Diffuse Alveolar Hemorrhage in a Patient with Acute Poststreptococcal Glomerulonephritis Caused by Impetigo

作者：Yoshida Masahiro^*; Yamakawa Hideaki; Yabe Masami; Ishikawa Takeo; Takagi Masamichi; Matsumoto Kei; Hamaguchi Akihiko; Ogura Makoto; Kuwano Kazuyoshi

来源：Internal Medicine, 2015, 54(8): 961-964.

DOI：10.2169/internalmedicine.54.3838

• diffuse alveolar hemorrhage
• pulmonary renal syndrome
• impetigo
• acute poststreptococcal glomerulonephritis
• Streptococcus pyogenes

We herein report a case of pulmonary renal syndrome with nephritis in a 17-year-old boy with diffuse alveolar hemorrhage (DAH) associated with acute poststreptococcal glomerulonephritis (APSGN). The patient exhibited hemoptysis two weeks after developing impetigo, and DAH was diagnosed on bronchoscopy. Respiratory failure progressed, and high-dose methylprednisolone therapy was administered; the respiratory failure regressed immediately after the onset of therapy. Streptococcus pyogenes was detected in an impetigo culture, and, together with the results of the renal biopsy, a diagnosis of APSGN was made. This case demonstrates the effects of high-dose methylprednisolone therapy in improving respiratory failure.

• 出版日期2015