A rare clinical course of seronegative of diffuse alveolar hemorrhage coexisting with extra-capillary glomerular

Abstract

Some disorders can cause concomitant kidney dysfunction with lung involvement. The diagnosis of diffuse alveolar hemorrhage (DAH) is considered in patients who develop progressive dyspnea with alveolar opacities on chest imaging and acute renal failure with proteinuria and hematuria occurs due to rapidly progressive glomerulonephritis (RPGN). These syndromes are caused by variable disorders the most frequent are ANCA associated vascularitis or goodpasture syndrome. DAH diagnosed by the presence of blood on bronchoscopic alveolar lavage, and RPGN by the presence of specific glomerular lesions on the renal biospy. Treatment should target the underlying disorder. Here, we describe in detail the clinical manifestations, diagnostic approach, and treatment of DHA in a 39-year-old male who presented an alveolar hemorrhage, with acute renal failure. Treatment involved the use of high-dose corticosteroids to suppress the autoimmune response. Finally, we discuss the striking response to corticosteroid treatment and emphasize the importance of early initiation of treatment.