We describe a case of diffuse scleroderma with a large pericardial effusion, pleural effusions, and subsequent oliguric renal failure. Histology of the pericardium and pleura revealed the presence of leukocytoclastic vasculitis. Pleuropericarditis in systemic sclerosis may occur on the basis of vasculitis. Large pericardial effusions may predispose to subsequent renal failure.