Scleroderma Renal Crisis: A Pathology Perspective

Batal, Ibrahim; Domsic, Robyn T.; Medsger, Thomas A.; Bastacky, Sheldon

doi:10.1155/2010/543704

Cited by 95 publications

(110 citation statements)

References 48 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…The histology displays proliferation and thickening of arcuate and interlobular arteriole intima, resulting in narrowing or full obliteration of vessels. There appears the typical picture of concentric (onion-like) hypertrophy 30 . The prognosis of this event is poor.…”

Section: Renal Crisismentioning

confidence: 99%

Emergency situations in rheumatology with a focus on systemic autoimmune diseases

Vymětal¹,

Skácelová²,

Smrzova³

et al. 2016

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

View full text Add to dashboard Cite

Background and Aim. Rheumatic diseases are commonly considered chronic conditions. However, acute manifestations can be very severe and represent a diagnostic problem. Examples are systemic lupus erythematosus with acute flare, glomerulonephritis, CNS disorders and catastrophic antiphospholipid syndrome, scleroderma with interstitial lung disease, pulmonary hypertension and renal crisis and polyangiitis with alveolar haemorhage and acute respiratory failure. This aim of this paper is to overview emergency situations which can be encountered in the care of patients with autoimmune systemic diseases and vasculitides. Methods. A Pubmed search for both original and review articles, recent textbooks and current guidelines related to rheumatic diseases with possible acute situations were included in this review article. Relevant image documentation was obtained at the site over the past several years of observation. Conclusions. This paper provides an overview of facts and emergency situations which can be encountered in the care of patients with autoimmune systemic diseases and vasculitides. It is directed at clinicians working in intensive care. It provides a differential diagnostic overview and information which is rare and commonly underestimated.

show abstract

Section: Renal Crisismentioning

confidence: 99%

Emergency situations in rheumatology with a focus on systemic autoimmune diseases

Vymětal¹,

Skácelová²,

Smrzova³

et al. 2016

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

View full text Add to dashboard Cite

show abstract

“…Vascular changes are accompanied by thromboses, the accumulation of myxoid material and the development of onion-skin lesions and fibrointimal sclerosis later in the disease course [29]. Vascular damage is a primary event in the pathogenesis of scleroderma.…”

Section: Connective Tissue Diseases and Sclerodermamentioning

confidence: 99%

Hypertensive Emergencies: a New Clinical Approach

Lagi

Cencetti

2014

J Hypertens

View full text Add to dashboard Cite

The expression 'hypertensive urgencies' includes many diseases. The unifying features of these diseases are a high level of arterial pressure and acute distress of one or more organs. The aim of the review was to define the idea of the 'acute hypertension' as a new concept, different from 'chronic hypertension'. Acute hypertension might be related to 'organ damage' because it is the cause, the consequence or an effect of the acute stress. We compounded a narrative review which has included analyses of 373 articles. The structure of the search strategy included a literature search of PubMed, MEDLINE, Cochrane Library and Google Scholar databases. We applied the following inclusion criteria: prospective double-blind randomised controlled trials, experimental animal work studies, case-control studies and recruiting patients representative of the general sick population. In this review, the diseases included in the term 'hypertensive emergencies' share 'acute' hypertension. This is a new idea that emphasises the suddenly increased arterial pressure, irrespective of the initial arterial pressure and independent of the goals of hypertension control. The 'hypertensive emergencies' have been grouped together in three subsets: (1) diseases that result from acute hypertension that is caused by faulty regulation of the peripheral circulation (acute primary hypertension), (2) diseases that produce hypertension (acute secondary hypertension) and 3) diseases that have hypertension as an effect of the acute stress caused by the principle disease (acute associated hypertension). This review highlights a novel idea: acute hypertension is a common sign of different diseases characterised by the sudden surge of arterial pressure, so overwhelming the difference between hypertensive emergencies and urgencies. The judgment of acute hypertension is independent of the initial arterial pressure, normotension or hypertension and is linked with the transient failure of the baroreflex. Hypertensive emergencies are grouped together because all of these diseases require prompt therapy to prevent the negative outcomes of acute hypertension

show abstract

“…Histologic correlate is presented by specific proliferation in the intima of arcuate and renal interlobular arteries and arterioles leading to narrowing or even obliteration of arteries with the formation of typical concentric hypertrophy ("onion skin") (ref. 10 ). Proliferative changes can be accompanied by arterial thrombosis and necrosis.…”

Section: Systemic Sclerodermamentioning

confidence: 99%

Renal manifestations of rheumatic diseases. A review

Horák¹,

Smrzova²,

Krejčí³

et al. 2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

View full text Add to dashboard Cite

Background. Renal manifestations of rheumatic diaseases are sometimes very discrete and mild. At others, they can present the leading symptomatology of a given disease. Systemic lupus erythematosus, systemic scleroderma, renal vasculitis, rheumatoid arthritis, mixed connective tissue disease, Sjögren's syndrome and gout can all manifest in or be accompanied by renal impairment. Methods and Results. The authors reviewed the literature on renal manifestation of rheumatic diseases using the key words, lupus erythematosus, systemic autoimmune diseases, rheumatoid arthritis, vasculitis and gout. The review below is accompanied by their own histological findings. Conclusion. Diagnosis requires proper interpretation of the clinical situation, laboratory results and image analysis methods plus close interdisciplinary collaboration between nephrologist and clinical pathologist/nephropathologist.

show abstract

Scleroderma Renal Crisis: A Pathology Perspective

Cited by 95 publications

References 48 publications

Emergency situations in rheumatology with a focus on systemic autoimmune diseases

Emergency situations in rheumatology with a focus on systemic autoimmune diseases

Hypertensive Emergencies: a New Clinical Approach

Renal manifestations of rheumatic diseases. A review

Contact Info

Product

Resources

About