Anti-RNA polymerase III antibodies in the diagnosis of scleroderma renal crisis sine scleroderma

We describe the use of antibodies to RNA polymerase III in the diagnosis of scleroderma in 2 patients who presented with renal crisis without other cl inical features of the condition. Both presented with accelerated hypertens ion, rapidly progressive acute renal failure, microangiopathic hemolytic an emia, and thrombocytopenia. One patient developed digital infarcts in the c ourse of his initial illness. Neither showed evidence of skin thickening at presentation. Nailfold capillaroscopy was normal in one patient and showed capillary dropout in the other Renal biopsy showed findings consistent wit h thrombotic microangiopathy and both had anti-RNA polymerase III antibodie s.