Pulmonary-renal syndrome: a life threatening but treatable condition.

Publisher: Oxford University Press Country of Publication: England NLM ID: 0234135 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1469-0756 (Electronic) Linking ISSN: 00325473 NLM ISO Abbreviation: Postgrad Med J Subsets: MEDLINE

Publication: 2023- : Oxford : Oxford University Press
Original Publication: London, Blackwell.

Anti-Glomerular Basement Membrane Disease/*diagnosis ; Glomerulonephritis/*diagnosis ; Glomerulonephritis/*drug therapy ; Hemorrhage/*diagnosis ; Hemorrhage/*drug therapy ; Lung Diseases/*diagnosis ; Lung Diseases/*drug therapy ; Vasculitis/*diagnosis; Anti-Glomerular Basement Membrane Disease/complications ; Anti-Glomerular Basement Membrane Disease/drug therapy ; Antibodies, Antineutrophil Cytoplasmic/immunology ; Diagnosis, Differential ; Humans ; Renal Insufficiency ; Respiratory Insufficiency/complications ; Respiratory Insufficiency/drug therapy ; Treatment Outcome ; Vasculitis/complications ; Vasculitis/drug therapy

Pulmonary renal syndrome (PRS) describes the occurrence of renal failure in association with respiratory failure, characterised by autoimmune-mediated rapidly progressive glomerulonephritis (RPGN) and diffuse alveolar haemorrhage (DAH), respectively. PRS is associated with significant morbidity and mortality, and prompt diagnosis and treatment significantly improve outcomes. Prompt diagnosis of PRS requires a high index of suspicion, as clinical features are non-specific, and immunological testing aids the diagnosis in many cases. The diagnostic evaluation of DAH and RPGN is outlined in the context of the important differential diagnoses. The commonest causes of PRS include antineutrophil cytoplasm antibody (ANCA)-associated vasculitis and antiglomerular basement membrane disease. As such, more emphasis has been placed on these two conditions in addition to an overview of the less common causes of PRS. We provide a practical review of the diagnostic evaluation, current treatment strategies and clinical outcomes of PRS for renal, respiratory and general physicians.

0 (Antibodies, Antineutrophil Cytoplasmic)

Rapidly progressive glomerulonephritis with pulmonary hemorrhage

Date Created: 20130126 Date Completed: 20131021 Latest Revision: 20220419

20240829

10.1136/postgradmedj-2012-131416

23349383