Pulmonary Renal Syndrome

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Contents 1 More Specific Terms 2 Etiology 3 Clinical-manifestations 4 Laboratory 5 Diagnostic-procedures 6 Radiology 7 Management 8 More General Terms 9 References

More Specific Terms

• anti-glomerular basement membrane [GBM] disease
• cryoglobulinemia (cryoglobulinemic vasculitis)
• endocarditis
• Wegener's granulomatosis

Etiology

• Wegener's granulomatosis
• anti-glomerular basement membrane disease ( anti-GBM disease)
• immune- complex disease ( cryoglobulinemia, endocarditis)

Clinical-manifestations

• cough, hemoptysis, pulmonary hemorrhage, alveolar hemorrhage
• glomerulonephritis
• sinusitis, nasal congestion, epistaxis, nasal ulcers ( Wegener's granulomatosis)
• arthralgias mylagias, fever, serositis skin rashes ( SLE)
• mononeuritis multiplex, cranial nerve palsy

Laboratory

• complete blood count ( CBC):

• anemia, leukopenia, thrombocytopenia ( SLE)

• urinalysis: hematuria, RBC casts ( glomerular disease)
• anti-neutrophil cytoplasmic antibody ( ANCA) (Wegner's granulomatosis)
• anti-GBM antibody ( anti-GBM disease)
• anti-dsDNA, anti-Sm antibody ( SLE)
• serum cyroglobulins (immune complex disease cryoglobulinemia)
• blood cultures immune complex disease ( endocarditis)

Diagnostic-procedures

• echocardiogram ( endocarditis)
• pulmonary function testing

Radiology

• chest X-ray:

• pulmonary infiltrates, pulmonary nodules ( Wegener's granulomatosis)

• renal ultrasound is normal in glomerulonephritis

Management

• anti-GBM disease

• plasmapheresis, corticosteroids, cyclophosphamide as indicated

• Wegener's granulomatosis, SLE:

• corticosteroids, cyclophosphamide as indicated

• see specific etiology

More General Terms

• syndrome
• kidney disease; renal disease
• lung disease

References

1. Medical Knowledge Self Assessment Program (MKSAP) 14, American College of Physicians, Philadelphia 2006

pulmonary-renal syndrome