A Case of Post-Streptococcal Glomerulonephritis with Diffuse Alveolar Hemorrhage

• Published in: Journal of Korean medical science 2007, 22(6), , pp.1074-1078
• Main Authors: Hye Young Sung, 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
• Format: Article
• Language: Korean
• Subjects: 의학일반
• ISSN: 1011-8934; 1598-6357

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. KCI Citation Count: 4