Renal angiographic findings in systemic sclerosis: ‘the Egyptian experience’

Abstract

AbstractObjective: This study was designed to search for a possible pathological involvement of renal arteries among patients with systemic sclerosis (SSc) and to correlate the findings with renal functions.Patients and methods: Fourteen female patients with SSc were recruited for this study. The diagnosis and classification of SSc was based on the 1980 American College of Rheumatology criteria for classification of SSc. Nine patients had diffuse‐type SSc, and the remaining five belonged to the limited type of the disease. All patients were evaluated by history‐taking, clinical examination, laboratory investigations and renal angiography.Results: Three out of the nine patients (33.3%) with diffuse SSc had tortuous renal arteries, but there were none in the limited type. Two patients (22.2%) with diffuse SSc had ectatic renal arteries and three (33.3%) had osteal renal artery stenosis. Tortuous abdominal aorta was detected in one patient (11.1%) with diffuse SSc and congenital double renal artery in another (11.1%). Two out of the five patients with limited‐type disease (40%) had osteal renal artery stenosis that was bilateral in one case. Bilateral renal artery affection was observed in 3/14 studied patients (21.42%), and two of these had diffuse disease and one had limited disease. Three patients had hypertension (two had diffuse pattern and one had limited pattern).Conclusion: We consider that renal artery stenosis is the most important among all the findings detected and should be considered in SSc patients presenting with renal crisis because use of angiotensin converting enzyme (ACE) inhibitors in this situation may be deleterious rather than beneficial.