pulmonary-renal syndrome

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) (Wegener'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

More specific terms

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