title: A case of post-streptococcal glomerulonephritis with diffuse alveolar hemorrhage.
abstract: 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.
authors.affiliation: Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hye Young
authors.initials: HY
authors.lastname: Sung
authors.forename: Chang Hoon
authors.initials: CH
authors.lastname: Lim
authors.forename: Mi Jung
authors.initials: MJ
authors.lastname: Shin
authors.forename: Byung Soo
authors.initials: BS
authors.lastname: Kim
authors.forename: Young Ok
authors.initials: YO
authors.lastname: Kim
authors.forename: Ho Chul
authors.initials: HC
authors.lastname: Song
authors.forename: Suk Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Euy Jin
authors.initials: EJ
authors.lastname: Choi
authors.forename: Yoon Sik
authors.initials: YS
authors.lastname: Chang
authors.forename: Byung Kee
authors.initials: BK
authors.lastname: Bang
mesh_terms: 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*