PT - JOURNAL ARTICLE AU - Carroll, Mitchell AU - Nagarajah, Vanitha AU - Campbell, Sian TI - Systemic sclerosis following COVID-19 infection with recurrent corticosteroid-induced scleroderma renal crisis AID - 10.1136/bcr-2022-253735 DP - 2023 Mar 01 TA - BMJ Case Reports PG - e253735 VI - 16 IP - 3 4099 - http://casereports.bmj.com/content/16/3/e253735.short 4100 - http://casereports.bmj.com/content/16/3/e253735.full SO - BMJ Case Reports2023 Mar 01; 16 AB - Systemic sclerosis is a complex multisystem connective tissue disease resulting in fibrosis of the skin and internal organs. Exposure to corticosteroids can trigger scleroderma renal crisis, a life-threatening complication of the disease. Autoimmune disease following infection with COVID-19 is being increasingly recognised. The mechanisms of post-COVID-19 autoimmunity are likely multifactorial, involving immune dysregulation, molecular mimicry and the development of cross-reactive antibodies. There are currently only two reported cases of systemic sclerosis occurring post-COVID-19 infection.We present the case of a female patient who developed systemic sclerosis post-COVID-19 infection. Following exposure to corticosteroids, the patient developed scleroderma renal crisis complicated by thrombotic microangiopathy, seizures and acute renal failure. Despite an antibody profile not typically associated with renal crisis (anti-topoisomerase positive, anti-RNA-polymerase III negative), the patient developed recurrent renal crisis with repeated exposure to corticosteroid therapy, highlighting the risk of steroid use in all patients with systemic sclerosis.