A Case of Post-Streptococcal Glomerulonephritis with Diffuse Alveolar Hemorrhage.
10.3346/jkms.2007.22.6.1074
- Author:
Hye Young SUNG
1
;
Chang Hoon LIM
;
Mi Jung SHIN
;
Byung Soo KIM
;
Young Ok KIM
;
Ho Chul SONG
;
Suk Young KIM
;
Euy Jin CHOI
;
Yoon Sik CHANG
;
Byung Kee BANG
Author Information
1. Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea. kbsnep@yahoo.co.kr
- Publication Type:Case Report
- Keywords:
Post-Streptococcal Glomerulonephritis;
Diffuse Alveolar Hemorrhage
- MeSH:
Biopsy;
Female;
Glomerulonephritis/*etiology;
Hemorrhage/*etiology;
Humans;
Kidney/pathology;
Lung Diseases/etiology;
Middle Aged;
*Pulmonary Alveoli;
Streptococcal Infections/*complications
- From:Journal of Korean Medical Science
2007;22(6):1074-1078
- CountryRepublic of Korea
- Language:English
-
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.
