Systemic sclerosis with renal crisis and pericardial effusion

Scleroderma renal crisis occurs in 10% of patients with systemic sclerosis carrying a poor prognosis. A kidney biopsy is consistent with thrombotic microangiopathy (TMA) with clinical findings discerning it from other TMAs. Progression to ESRD occurs in 50% of patients which can lead to further complications necessitating emergent interventions including dialysis. Patients with scleroderma can have pericardial involvement with tamponade physiology requiring intervention such as pericardiocentesis.