# A Case of Diffuse Scleroderma Presenting as Hypertensive Encephalopathy Due to Scleroderma Renal Crisis

## TL;DR

A 38-year-old woman with diffuse scleroderma developed a life-threatening kidney crisis that caused severe high blood pressure and brain issues.

## Contribution

This case highlights a rare and severe presentation of scleroderma renal crisis mimicking hypertensive encephalopathy.

## Key findings

- The patient's scleroderma presented as a life-threatening renal crisis with severe hypertension.
- Timely diagnosis and treatment with ACE inhibitors and hydroxychloroquine improved outcomes.
- The case emphasizes the need to consider scleroderma in patients with unexplained hypertensive encephalopathy.

## Abstract

This case report details a rare presentation of diffuse scleroderma, where a 38-year-old female developed hypertensive encephalopathy due to scleroderma renal crisis (SRC). SRC, characterized by sudden severe hypertension and renal failure, poses a life-threatening emergency. The patient's clinical features, including skin changes and abnormalities on nailfold capillaroscopy, facilitated the diagnosis of diffuse scleroderma. Comprehensive diagnostic investigations revealed multisystem involvement. Management involved angiotensin-converting enzyme inhibitors, hydroxychloroquine, and packed red cell transfusions, highlighting a holistic therapeutic approach. This case underscores the importance of recognizing diverse scleroderma manifestations in hypertensive emergencies for timely intervention and improved outcomes.