Resolution of hypertensive encephalopathy and scleroderma renal crisis with an angiotensin receptor blocker

The use of an angiotensin II type-1 receptor blocker for scleroderma renal crisis is controversial. We describe a 46-year-old woman presenting with a seizure secondary to hypertensive encephalopathy as the initial manifestation of scleroderma renal crisis. She had complete resolution of end organ damage with use of an angiotensin II type-1 receptor blocker. There may be a role for angiotensin II type-1 receptor blockers in the setting of scleroderma renal crisis with central nervous system involvement.