{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T14:39:54Z","timestamp":1775572794499,"version":"3.50.1"},"reference-count":26,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,5,3]]},"abstract":"<jats:p>A patient presented with neuromuscular, respiratory and cardiac symptoms and was initially diagnosed with amyotrophic lateral sclerosis (ALS), myocardial ischaemia and pneumonia. He developed unexplained progressive kidney failure over the ensuing week, and his kidney biopsy showed thrombotic microangiopathy that led to the correct diagnosis of normotensive scleroderma renal crisis. His clinical presentation and course were consistent with systemic sclerosis and normotensive scleroderma renal crisis. He was treated with an ACE inhibitor (ACEi) and haemodialysis with significant functional improvement over the next 3\u2005months to his prior baseline with the exception of kidney failure. This case highlights a diagnostic challenge requiring astute history and physical examination skills, and the value of a kidney biopsy in providing the final diagnosis.<\/jats:p>","DOI":"10.1136\/bcr-2013-202566","type":"journal-article","created":{"date-parts":[[2014,5,29]],"date-time":"2014-05-29T05:18:50Z","timestamp":1401340730000},"page":"bcr2013202566","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Mistaken identity: normotensive scleroderma renal crisis"],"prefix":"10.1136","volume":"2014","author":[{"given":"Arwa","family":"Aburizik","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Iowa, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siddharth","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laith","family":"Al-Rabadi","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Iowa, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Blosser","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Nephrology, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,5,29]]},"reference":[{"key":"2025082802521842000_2014.may29_1.bcr2013202566.1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-006-0211-8"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199805)41:5<778::AID-ART4>3.0.CO;2-V"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2008.06.002"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.4","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1097\/00005792-198311000-00001","article-title":"Hypertension and renal failure (scleroderma renal crisis) in progressive systemic sclerosis. Review of a 25-year experience with 68 cases","volume":"62","author":"Traub","year":"1983","journal-title":"Medicine"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.5","first-page":"649","article-title":"Kidney disease other than renal crisis in patients with diffuse scleroderma","volume":"32","author":"Steen","year":"2005","journal-title":"J Rheumatol"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-857X(03)00016-4"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.7","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1016\/j.bbadis.2010.03.012","article-title":"Therapeutic potential of endothelin receptor antagonists for chronic proteinuric renal disease in humans","volume":"1802","author":"Barton","year":"2010","journal-title":"Biochim Biophys Acta"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.8","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcm052"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.9","doi-asserted-by":"publisher","DOI":"10.1002\/anr.1780320911"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.10","doi-asserted-by":"publisher","DOI":"10.1097\/00002281-200011000-00009"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.11","doi-asserted-by":"publisher","DOI":"10.1002\/art.22036"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.12","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-004-0057-5"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.13","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.066985"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2005.03.005"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.15","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-012-1949-9"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.16","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1951.02920340008003"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197906213002505"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.18","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-113-5-352"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2010.05.018"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.20","doi-asserted-by":"publisher","DOI":"10.1002\/art.22965"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.21","first-page":"135","article-title":"Effect of dihydropyridine calcium channel blockers and glucocorticoids on the prevention and development of scleroderma renal crisis in an Italian case series","volume":"31","author":"Montanelli","year":"2013","journal-title":"Clin Exp Rheumatol"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2005.01035.x"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.23","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-008-0807-1"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.24","doi-asserted-by":"publisher","DOI":"10.1097\/01.smj.0000229871.68911.67"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.25","first-page":"479","article-title":"A case of normotensive scleroderma renal crisis after high-dose methylprednisolone treatment","volume":"53","author":"Kohno","year":"2000","journal-title":"Clin Nephrol"},{"key":"2025082802521842000_2014.may29_1.bcr2013202566.26","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-004-0379-1"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-202566","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:52:26Z","timestamp":1756374746000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-202566"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,5,29]]},"references-count":26,"alternative-id":["10.1136\/bcr-2013-202566"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-202566","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,5,29]]}}}