Case report: Nephrotic range proteinuria: Rare manifestation of scleroderma renal crisis

Manish Nepal, Roshan Mainali, Charles M. Schworer, William Difilippo, Ping L. Zhang, Michael F. Schultz

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


The nephrotic range of proteinuria is uncommon in scleroderma renal crisis. This 46-yr-old woman with a medical history of scleroderma presented with very high blood pressure, a sudden elevation of serum creatinine, and proteinuria in the nephrotic range. Renal biopsy revealed onion-skin type of arterial changes with necrosis, confirming the presence of scleroderma nephropathy. Electron microscopy showed diffuse fusion of foot processes. Immunohistochemical staining (IHC) revealed increased expression in glomeruli of phosphorylated mammalian target of rapamycin (p-mTOR). These findings suggest that fusion of foot processes and activation of mammalian target of rapamycin-dependent pathways in podocytes are most likely responsible for the severe proteinuria in this patient with scleroderma nephropathy.

Original languageEnglish (US)
Pages (from-to)163-167
Number of pages5
JournalAnnals of Clinical and Laboratory Science
Issue number2
StatePublished - Mar 1 2008


  • Phosphorylated mammalian target of rapamycin
  • Proteinuria
  • Scleroderma renal crisis

ASJC Scopus subject areas

  • Microbiology
  • Immunology and Allergy
  • Pathology and Forensic Medicine
  • Immunology
  • Molecular Biology
  • Hematology
  • Clinical Biochemistry
  • Medical Laboratory Technology


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