Bloodless Glomeruli: A Case Report on Scleroderma Renal Crisis

Sunit Tolia, Hassan Kassem, Samira Ahsan


Scleroderma renal crisis (SRC) is a main complication of systemic sclerosis affecting approximately one-fifth of the patient population with the disease. We present a case of a 38-year-old African American female who initially presented with findings suggestive of thrombotic thrombocytopenic purpura; however, the clinical manifestations, laboratory findings and renal biopsy confirmed the diagnosis of SRC. The case is worth reporting in medical literature because of its unique presentation and to note the findings of the kidney biopsy. SRC can present initially as thrombotic thrombocytopenic purpura; therefore, clinicians need to be more aware of this entity and it should be considered in the differential diagnosis of microangiopathic hemolytic anemia. This case also illustrates that the classic onion skin appearance on kidney biopsy in SRC is not always present and that patients can have bloodless glomeruli.

J Med Cases. 2018;9(7):229-232


Scleroderma; Scleroderma renal crisis; Microangiopathic hemolytic anemia; Thrombocytopenia; Thrombotic thrombocytopenic purpura

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