A Rare Clinical Course of Seronegative Pulmonary-Renal Syndrome

Abstract EN

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.