Scleroderma Renal Crisis Complicated with Thrombotic Microangiopathy Triggered by Influenza B Virus Infection

Intern Med. 2019 Feb 1;58(3):441-445. doi: 10.2169/internalmedicine.1441-18. Epub 2018 Aug 24.

Abstract

A 44-year-old Japanese man with a 14-year history of limited cutaneous systemic sclerosis (SSc) was admitted with a fever, hypertension, anemia, thrombocytopenia, and renal dysfunction. On admission, hypertension, hyperreninemia, acute renal dysfunction, hemolytic anemia, and thrombocytopenia led to the diagnosis of scleroderma renal crisis (SRC) complicated with thrombotic microangiopathy (TMA). The patient had also been infected with influenza B virus almost six days before admission. Following treatment with plasma exchange, an angiotensin-converting enzyme inhibitor, and an anti-virus agent, his general condition improved. He had no risk factors for SRC. In SSc patients, an influenza virus infection might trigger SRC complicated with TMA.

Keywords: SSc; TMA; influenza virus; scleroderma renal crisis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Antiviral Agents / therapeutic use
  • Humans
  • Hypertension, Renal / etiology
  • Influenza B virus
  • Influenza, Human / complications*
  • Influenza, Human / therapy
  • Male
  • Plasma Exchange / methods
  • Risk Factors
  • Scleroderma, Systemic / complications*
  • Scleroderma, Systemic / therapy
  • Thrombotic Microangiopathies / complications*
  • Thrombotic Microangiopathies / therapy

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Antiviral Agents