Scleroderma Renal Crisis Symptoms | Medical Algorithm

Are you evaluating a patient with diffuse or limited cutaneous systemic sclerosis?

Yes

Has the patient had a new onset increase in systolic and diastolic blood pressure confirmed at least twice?

Yes

Systolic blood pressure

mm Hg

Diastolic blood pressure

mm Hg

Baseline estimated GFR BSA (enter 90 if unknown)

mL per min per square m

Current estimated GFR BSA

mL per min per square m

Does the patient have?

• microangiopathic hemolytic anemia?

Yes

• retinal changes of acute hypertensive crisis?

Yes

• new onset of microscopic hematuria not due to another causes?

Yes

• flash pulmonary edema?

Yes

• oliguria or anuria?

Yes

• histologic changes of scleroderma in a renal biopsy?

Yes

Does the renal biopsy show a evidence of an alternative explanation for the clinical changes?

Yes

Is there another diagnosis that explain the clinical and laboratory findings better?

Yes

Results

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Results Interpretation and Description References Next Steps

Data complete?

Evaluation appropriate?

Percent reduction in GFR

Does the patient meet the basic criteria for a scleroderma renal crisis?

Number of supportive findings for a scleroderma renal crisis

Is there an alternative explanation that explains the diagnosis?

Should you consider the diagnosis of scleroderma renal crisis in this patient?

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Risk Factors
- Scleroderma Risk Model for 5 Year Survival
Clinical Diagnosis, Including Family History For Genetics
- ARA Scleroderma Criteria Cooperative Study Preliminary Clinical Criteria for Systemic Sclerosis
Imaging Studies
Laboratory Tests
Other Testing
Criteria For Diagnosis
Severity, Prognosis, Stage
Differential Diagnosis And Mimics, Red Flags

Therapy

Physical And Lifestyle
- Drug Induced Scleroderma

Monitoring

Response To Therapy
Disease Progression
Comorbid Conditions
- Prognostic Factors for Patient with Juvenile Systemic Sclerosis
- Lung Severity Scale of Medsger for Patient with Systemic Sclerosis

Patient Concerns

End-of-life, Palliative Care
- Scleroderma Risk Model for 5 Year Survival

Evaluation

Results

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Therapy

Monitoring

Patient Concerns

Specialty

Objective

ICD-10

Criteria for Scleroderma Renal Crisis

Purpose: To determine if a patient with scleroderma has developed scleroderma renal crisis based on the criteria of Penn et al.

Evaluation

Results

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Therapy

Monitoring

Patient Concerns

Specialty

Objective

ICD-10