Malignant Hypertension with Pulmonary Alveolar Hemorrhage Needing Dialysis.
10.12771/emj.2017.40.2.87
- Author:
Younghun KIM
1
;
Ki Tae BANG
;
Jong Ho SHIN
;
Ju Ri KIM
;
Joo Heon KIM
;
Jin Uk JEONG
Author Information
1. Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea. jjo9428@eulji.ac.kr
- Publication Type:Case Report
- Keywords:
Hypertension, malignant;
Acute kidney injury;
Pulmonary alveoli
- MeSH:
Acute Kidney Injury;
Adult;
Antihypertensive Agents;
Arteries;
Arterioles;
Biopsy;
Blood Pressure;
Capillaries;
Creatinine;
Dialysis*;
Dyspnea;
Hemoptysis;
Hemorrhage*;
Humans;
Hypertension, Malignant*;
Necrosis;
Pulmonary Alveoli;
Radiography;
Renal Dialysis;
Renal Replacement Therapy;
Thorax;
Vascular System Injuries
- From:The Ewha Medical Journal
2017;40(2):87-90
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 35-year-old man presented with progressive dyspnea and hemoptysis. His blood pressure was 230/140 mmHg and serum creatinine level was 20.13 mg/dL. Chest radiography and computed tomography revealed pulmonary hemorrhage. His renal function was low, thus emergent renal replacement therapy was required. Malignant hypertension and acute kidney injury were diagnosed, and antihypertensive therapy and hemodialysis started immediately. Renal biopsy was performed to examine the underlying disease. Typical pathological changes of malignant hypertension, fibrinoid necrosis of the afferent arterioles, and proliferative endoarteritis at the interlobular arteries were observed. His renal function improved gradually and pulmonary hemorrhage completely disappeared with administration of antihypertensive agents. Here, we report this rare case of malignant hypertension with pulmonary alveolar hemorrhage and speculate that the hemorrhage may be related to vascular injuries at the alveolar capillary level caused by malignant hypertension.
