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KMID : 0191120070220061074
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Journal of Korean Medical Science
2007 Volume.22 No. 6 p.1074 ~ p.1078
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A Case of Post-Streptococcal Glomerulonephritis with Diffuse Alveolar Hemorrhage
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Sung Hye-Young
Lim Chang-Hoon
Shin Mi-Jung
Kim Byung-Soo
Kim Young-Ok
Song Ho-Cheol
Kim Suk-Young
Choi Euy-Jin
Chang Yoon-Sik
Bang Byung-Kee
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Abstract
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Acute post-streptococcal glomerulonephritis (PSGN) is characterized by an abrupt onset of edema, hypertension, and hematuria. Life-threatening diffuse alveolar hemorrhage (DAH) is rarely associated with acute PSGN. There have been only two reported cases worldwide, and no case has been reported previously in Korea. Here, we present a patient who clinically presented with pulmonary-renal syndrome; the renal histology revealed post-infectious glomerulonephritis of immune complex origin. A 59-yr-old woman was admitted with oliguria and hemoptysis two weeks after pharyngitis. Renal insufficiency rapidly progressed, and respiratory distress developed. Chest radiography showed acute progressive bilateral pulmonary infiltrates. The clinical presentation suggested DAH with PSGN. Three days after treatment with high-dose steroids, the respiratory distress and pulmonary infiltrates resolved. Electron microscopy of a renal biopsy specimen sample revealed diffuse proliferative glomerulonephritis with characteristic subendothelial deposits of immune complex (‘‘hump’’). The renal function of the patient was restored, and the serum creatinine level was normalized after treatment.
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KEYWORD
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Post-Streptococcal Glomerulonephritis, Diffuse Alveolar Hemorrhage
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