A YOUNG GENTLEMAN WITH SERONEGATIVE PULMONARY RENAL SYNDROME
DR NOR HASHIMAH ABU MANSOR MATARDIAH
INTERNAL MEDICINE UKM
DR SHAMILA KARUTHU
The term pulmonary–renal syndrome refers to the combination of diffuse alveolar haemorrhage and rapidly progressive glomerulonephritis. Pathogenesis of this syndrome involved variety of mechanisms including antiglomerular basement membrane antibodies, antineutrophil cytoplasm antibodies or immunocomplexes and thrombotic.
We report a case of a 26 year old gentleman who presented with pulmonary and renal symptoms, suspected to have pulmonary renal syndrome. Patient’s bronchoscopy showed vasculitic changes and renal biopsy had inadequate sample. Both antineutrophil cytoplasmic autoantibody and antiglomerular basement membrane antibodies were negative. Patient was treated with plasma exchange and immunosuppresive drug but he remained dialysis dependent. In this report, we illustrate the clinical picture of seronegative pulmonary renal syndrome.
CASE REPORT…show more content… He had few episodes of hemoptysis 1 week prior to admission, small amount of fresh blood mixed with sputum. He had loss of appetite and significant weight loss but not able to quantify it. Otherwise, no night sweat, no symptoms of connective tissue disease and other systemic review was unremarkable. He had no past medical history, no significant family history, denied taking traditional treatment or any supplement and denied high risk behavior. He had been staying in Malaysia for past 5 years but had been caught to the prison for 1 year and just released about 2 weeks prior to hospital