A case of post-streptococcal glomerulonephritis with diffuse alveolar hemorrhage.
Acute post-streptococcal glomerulonephritis (PSGN) is characterized by an abrupt onset of edema, hypertension, and hematuria. Life-threatening diffuse alveolar hemorrhage (DAH) is rarely associated with acute PSGN. There have been only two reported cases worldwide, and no case has been reported previously in Korea. Here, we present a patient who clinically presented with pulmonary-renal syndrome; the renal histology revealed post-infectious glomerulonephritis of immune complex origin. A 59-yr-old woman was admitted with oliguria and hemoptysis two weeks after pharyngitis. Renal insufficiency rapidly progressed, and respiratory distress developed. Chest radiography showed acute progressive bilateral pulmonary infiltrates. The clinical presentation suggested DAH with PSGN. Three days after treatment with high-dose steroids, the respiratory distress and pulmonary infiltrates resolved. Electron microscopy of a renal biopsy specimen sample revealed diffuse proliferative glomerulonephritis with characteristic subendothelial deposits of immune complex (''hump''). The renal function of the patient was restored, and the serum creatinine level was normalized after treatment.
Sung
Hye Young
HY
Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
Lim
Chang Hoon
CH
Shin
Mi Jung
MJ
Kim
Byung Soo
BS
Kim
Young Ok
YO
Song
Ho Chul
HC
Kim
Suk Young
SY
Choi
Euy Jin
EJ
Chang
Yoon Sik
YS
Bang
Byung Kee
BK
D001706:Biopsy; D005260:Female; D005921:Glomerulonephritis / Q000209:etiology*; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D007668:Kidney / Q000473:pathology; D008171:Lung Diseases / Q000209:etiology; D008875:Middle Aged; D011650:Pulmonary Alveoli; D013290:Streptococcal Infections / Q000150:complications*