Diffuse alveolar haemorrhage in ANCA-negative pauci-immune crescentic glomerulonephritis
NDT Plus, ISSN: 1753-0784, Vol: 3, Issue: 5, Page: 449-452
2010
- 5Citations
- 7Captures
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Metrics Details
- Citations5
- Citation Indexes5
- CrossRef1
- Captures7
- Readers7
Article Description
Pulmonary renal syndrome (PRS) is a combination of diffuse pulmonary haemorrhage and glomerulonephritis (GN). Though an established form of presentation in anti-neutrophil cytoplasmic autoantibody (ANCA)-associated GN and vasculitis, diffuse pulmonary haemorrhage is extremely unusual in those with ANCA-negative GN. We present here a case of a 76-year-old Hispanic female with stage IV chronic kidney disease (serum creatinine of 2 mg/dL), who presented with diffuse alveolar haemorrhage and nephritic syndrome. Less than 1 week prior to the full-blown PRS, she was treated for an apparent pneumonia as was evidenced by a right lower lobe infiltrate on her chest X-ray. Retrospectively, this was likely a focal pulmonary haemorrhage. ANCA were persistently negative, and the remainder of her immunologic workup was normal. Renal biopsy was diagnostic of crescentic pauci-immune GN. The patient required a ventilator and haemodialysis support (serum creatinine 6 mg/dL), and was successfully treated with methylprednisolone, cyclophosphamide and a total of six cycles of plasmapheresis. Once her oliguria resolved, the creatinine plateaued at 2.7 mg/dL. Our case illustrates that diffuse alveolar haemorrhage can be a distinct clinical feature even in patients with ANCA-negative pauci-immune crescentic glomerulonephritis. © 2010 The Author . Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=77956968427&origin=inward; http://dx.doi.org/10.1093/ndtplus/sfq121; http://www.ncbi.nlm.nih.gov/pubmed/25984050; https://academic.oup.com/ckj/article-lookup/doi/10.1093/ndtplus/sfq121; https://dx.doi.org/10.1093/ndtplus/sfq121; https://academic.oup.com/ckj/article/3/5/449/445961
Oxford University Press (OUP)
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