Bloodless Glomeruli: A Case Report on Scleroderma Renal Crisis

Abstract

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 doi: https://doi.org/10.14740/jmc3018w