Medical Health Encyclopedia

Renal Crisis. The most serious kidney complication is renal crisis. It is a rare event that occurs in a minority of patients with diffuse scleroderma, most often early in the course of the disease. This syndrome includes a life threatening condition called malignant hypertension, a sudden increase in blood pressure that can cause rapidly progressive kidney failure. This condition may be fatal. If the condition is successfully treated, however, recurrence is rare.

Until recently, renal crisis was the most common cause of death in scleroderma. Aggressive treatment with anti-hypertensive drugs, particularly those known as angiotensin-converting enzyme (ACE) inhibitors, is proving to be successful in reducing this risk.

Heart Complications

Many patients with even limited scleroderma have some sort of functional heart problem, although severe complications are uncommon and occur in only about 15% of patients with diffuse scleroderma. As with other serious organ complications, they are more likely to occur within three years of the onset of the disease.

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Fibrosis of the Heart. The most direct effect that scleroderma has on the heart is fibrosis (scarring). It may be very mild or it can cause pain, lower blood pressure, or lead to other complications. By damaging muscle tissue it increases the risk for heart rhythm disturbances, problems in electrical conduction, and congestive heart failure. The membrane around the heart can become inflamed, causing a condition called pericarditis.

Click the icon to see an image of pericarditis.

Effects of Pulmonary Hypertension. Pulmonary hypertension and kidney problems associated with scleroderma can also affect the heart.

Gastrointestinal Complications

The following complications may occur in the gastrointestinal (GI) tract.