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

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  • Shimizu Toshimasa
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Iwamoto Naoki
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Okamoto Momoko
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Endo Yushiro
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Tsuji Sosuke
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Takatani Ayuko
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Igawa Takashi
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Umeda Masataka
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Fukui Shoichi
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Sumiyoshi Remi
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Kitamura Mineaki
    Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Koga Tomohiro
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Kawashiri Shin-ya
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Ichinose Kunihiro
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Tamai Mami
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Nakamura Hideki
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Origuchi Tomoki
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan Department of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Nishino Tomoya
    Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Kawakami Atsushi
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan

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Abstract

<p>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. </p>

Journal

  • Internal Medicine

    Internal Medicine 58 (3), 441-445, 2019-02-01

    The Japanese Society of Internal Medicine

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