Vol.21 No.3

Case Report

Pulmonary hypertension confirmed histologically five months prior to scleroderma renal crisis onset

Authors

Ryu Watanabe1 , Izaya Nakaya1 , Mayumi Yahata1 , Tohru Takahashi2 , Tomomi Sasajima3 , Kenichi Takeuchi3 , Hiroyuki Oura4 , Tsutomu Sakuma5 , Nobukazu Tomichi5 , Yasuki Mori6 , Jun Soma1

  • Department of Nephrology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka Iwate, 020-0060, Japan
  • Department of Cardiology, Iwate Prefectural Central Hospital, Morioka, Japan
  • Department of Respiratology, Iwate Prefectural Central Hospital, Morioka, Japan
  • Department of Respiratory Surgery, Iwate Prefectural Central Hospital, Morioka, Japan
  • Department of Pathology, Iwate Prefectural Central Hospital, Morioka, Japan
  • Department of Dermatology, Iwate Prefectural Central Hospital, Morioka, Japan
Received:

22 June 2010

Accepted:

14 November 2010

Published online:

21 December 2010

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Abstract

A 69-year-old man presented shortness of breath and acute renal failure. He had undergone pulmonary partial resection for lung cancer 5 months prior. On examination, severe hypertension, skin sclerosis of his forearms, and anticentromere antibody were observed. A renal biopsy specimen showed characteristic findings for scleroderma renal crisis, and a right heart catheterization revealed severe pulmonary arterial hypertension. Re-examination of the resected lung specimen revealed sclerodermatous vascular involvement was present.

Key words

Acute kidney injury - Endothelial damage - Limited cutaneous scleroderma - Lung fibrosis - Prostanoids