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. 2016:2016:4893496.
doi: 10.1155/2016/4893496. Epub 2016 Oct 27.

A Rare Clinical Course of Seronegative Pulmonary-Renal Syndrome

M Fröhlich-Gildhoff  1 , W J Jabs  2 , C Berhold  1 , M K Kuhlmann  2 , U Ketterer  1 , S Kische  1 , H Ince  1
Affiliations

A Rare Clinical Course of Seronegative Pulmonary-Renal Syndrome

M Fröhlich-Gildhoff et al. Case Rep Crit Care. 2016.

Abstract

Purpose. Pulmonary-renal syndrome (PRS) is characterized by diffuse alveolar hemorrhage and rapidly progressive glomerulonephritis mainly due to autoimmune etiologies. Seronegative PRS is a challenging entity to the clinician, since early diagnosis may be missed leading to delayed appropriate treatment. Materials and Methods. We present the clinical course of a 77-year-old patient who was admitted under the suspected diagnosis of pneumogenic sepsis and septic renal failure with fever, dyspnea, and elevated CRP levels. The diagnosis of pulmonary-renal syndrome was initially missed because of the absence of autoantibodies in all serological findings. Results. Despite delayed initiation of immunosuppressive therapy and a prolonged period of dialysis and extracorporeal membrane oxygenation the patient recovered well and was released to a rehabilitation center with nearly normalized creatinine levels. The diagnosis of PRS was established by renal biopsy. Conclusion. This case illustrates the important differential diagnosis of seronegative pulmonary-renal syndrome in patients with pulmonary and renal impairment.

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Figures

Figure 1
Figure 1
Illustrating diffuse bilateral infiltrates of the lung.
See this image and copyright information in PMC

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