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Scleroderma Renal Crisis
- abrupt onset of accelerated hypertension
- renal impairment
- life-threatening
- patient awareness critical
- outcome transformed by ACE inhibitors
- affects 10% of diffuse cutaneous and 1% of limited cutaneous
Management
- ACE-inhibitors
- iloprost
- gradual blood pressure lowering (unless compelling reason for lowering)
- renal biopsy when safe
- HDU nursing
- renal support
- plasma exchange
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