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- Osamu Yamazaki, Masataka Murakawa, Fumika Ochiai, Wataru Fujii, Shinichiro Asakawa, Michito Nagura, Shigeyuki Arai, Yoshifuru Tamura, Ryuji Ohashi, Shigeru Shibata, and Yoshihide Fujigaki.
- Department of Internal Medicine, Teikyo University School of Medicine, Japan.
- Intern. Med. 2024 Aug 15; 63 (16): 230123062301-2306.
AbstractA middle-aged woman presented with hypertensive emergency after corticosteroid treatment for Sjögren syndrome-associated multiple mononeuropathy with suspected systemic sclerosis. Hypertensive heart failure with hyperreninemia improved with antihypertensives, including aliskiren; however, she became hemodialysis-dependent. Clinical findings and biopsy-proven thrombotic microangiopathy indicated conditions resembling scleroderma renal crisis (SRC). Severe hypertension and heart failure with hyperreninemia occurred after stopping aliskiren for hypotension due to diverticular bleeding, which improved after the reintroduction of aliskiren. Aliskiren appears to be effective in managing hypertensive heart failure in patients with SRC. Nevertheless, hemodialysis remained necessary in our case, and whether or not aliskiren can restore the renal function is unclear.
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