Pulmonary Hemorrhage with Acute Renal Injury in
a Patient with IgA Nephropathy
Chatchai Kreepala MD*,
Siribha Changsirikulchai MD*, Panas Chalermsanyakorn MD**
Affiliation :
* Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
** Department of Pathology, Faculty of Medicine, Ramathibodi Hospital Bangkok, Thailand
IgA nephropathy (IgAN) is a form of glomerular diseases which is usually aggravated by infection in
respiratory or gastrointestinal systems. The clinical manifestations in IgAN can be asymptomatic microscopic
hematuria, gross hematuria, nephritic syndrome, nephrotic syndrome or acute renal injury from crescentic
glomerulonephritis. Acute interstitial nephritis (AIN) has been previously described as an unusual cause of
acute renal injury in IgAN. Hemoptysis from diffuse pulmonary hemorrhage is a rare manifestation in IgAN. We
reported a patient who presented with fever, hemoptysis from diffuse pulmonary hemorrhage, and acute renal
injury. Renal biopsy revealed IgAN concomitant with AIN which was the cause of renal dysfunction. We
conclude that pulmonary hemorrhage and acute interstitial nephritis can be found in IgAN. The etiology of
pulmonary hemorrhage and acute interstitial nephritis might be from infection. Renal biopsy is a mandatory
investigation to make the correct diagnosis.
Keywords : Acute disease, Glomerulonephritis, IGA, Hemorrhage, Immunoglobulin A, Kidney diseases, Lung
diseases, Interstitial
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