Which of the kidney vasculitides are associated with Pulmonary renal syndrome?
Pulmonary-renal syndrome describes the presentation of acute glomerulonephritis with alveolar hemorrhage, as demonstrated by radiographic demonstration of pulmonary infiltrates and varying degrees of hypoxia, hemoptysis, and anemia. It is a life-threatening complication of small-vessel vasculitis.
The ANCA small-vessel vasculitides are the most common cause of pulmonary-renal syndrome. Anti-GBM disease, or Goodpasture’s disease, may also present with pulmonary hemorrhage and concomitant rapidly progressive glomerulonephritis. This syndrome may also be seen in patients with SLE and similar connective tissue diseases, IgA vasculitis (Henoch-Schölein purpura), and in cryoglobulinemic vasculitis.
Patients with this presentation should also be evaluated for other conditions accompanying kidney failure that may have similar presentations, including pneumonia and pulmonary embolus.
