Of 140 patients with "scleroderma renal crisis" encountered during a 33-year period, 15 of 131 (11%) whose blood pressures were recorded were normotensive during this complication. In comparison with 116 patients with hypertension, the normotensive patients significantly more often had microangiopathic hemolytic anemia (90% versus 38%) and thrombocytopenia (83% versus 21%). Pulmonary hemorrhage occurred in 6 normotensive patients. More normotensive patients had received high doses of corticosteroids (prednisone 2 3 0 mg/day) during the 2 months immediately preceding renal crisis (64% versus 16%). A role for corticosteroids in precipitating renal crisis is suggested. The 12-month survival was significantly reduced in the normotensive patients (13% versus 35%).Systemic sclerosis (SSc; scleroderma) is a multisystem connective tissue disease in which the most prominent manifestation is thickening of the skin due to excessive collagen deposition in the dermis. One of the life-threatening visceral involvements is "sclero-

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Paget's disease of bone is most commonly seen in the spine; it may either be asymptomatic or may cause pain and neurologic impairment. We describe a patient with back pain due to Paget's disease of the second lumbar vertebra and spinal stenosis. The patient had a dramatic clinical and radiographic response to 2 courses of etidronate disodium, which was evidenced by resolution of the back pain and improvement in bony spinal stenosis. Etidronate may be effective in reversing bony spinal stenosis due to Paget's disease.