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Case Reports
. 2018 Dec 17:2018:3273695.
doi: 10.1155/2018/3273695. eCollection 2018.

Malignant Hypertension Causing a Pulmonary-Renal Syndrome

Bryan Yong  1 , David A Power  2
Affiliations
Case Reports

Malignant Hypertension Causing a Pulmonary-Renal Syndrome

Bryan Yong et al. Case Rep Nephrol. .

Abstract

Background: Pulmonary-renal syndrome is characterised by acute kidney injury, haematuria, and haemoptysis and is a well-recognised presentation of diseases such as ANCA vasculitis that require urgent immunosuppression.

Case presentation: A patient presented with a brief history of haemoptysis, acute renal failure, microscopic haematuria, and severe hypertension. The diagnosis was initially not clear so he was treated with antihypertensives, renal replacement therapy, and immunosuppression. Renal biopsy subsequently showed evidence of malignant hypertension. Autoantibodies were uniformly negative.

Conclusions: This case demonstrates that malignant hypertension can present as pulmonary-renal syndrome.

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Figures

Figure 1
Figure 1
Right and left funduscopic images showing flame haemorrhages and cotton wool spots, consistent with grade 3 hypertensive retinopathy.
Figure 2
Figure 2
Renal biopsy. Left: arteriolar thickening and myxoid changes. Top right: negative immunofluorescence staining. Bottom right: onion skinning of arterioles on silver staining.
See this image and copyright information in PMC

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