Scleroderma   

No history of malignancy. No Raynauds. 

The patient has tried conservative measures with compression stockings.

Do you generally recommend anti-diarrheals, dietary modifications, or consider this an unacceptable side effect and move to other therapies? 

The patient is a young African American female of reproductive age with positive Fibrillarin antibody and nucleolar antibody. No ILD.

Patient with nephrotic range proteinuria, but there is no evidence of active TMA on renal biopsy.