Physiology

• Deposition of immune complexes with complement in the glomerulus

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Pathology

• Pathology with Diffuse Alveolar Hemorrhage: pulmonary capillaritis

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Diagnosis

• PFT’s: increased DLCO during DAH
• FOB
  • BAL: RBC’s/ hemosiderin-laden macrophages
• OLB: may be necessary
  • Absence of immune complex deposits
• CXR/Chest CT patterns: diffuse or patchy focal alveolar infiltrates
  • Interstitial infiltrates appear with chronic or recurrent DAH
• Serology
  • ANA:
  • Anti-DNA:
  • RF:
  • C3/C4/CH50:
  • ANCA: negative
  • Anti-GBM: negative
• ESR:
• CBC:
• Urinalysis: abnormal
• Renal Bx: focal segmental necrotizing GLN/ crescents
  • Tissue Ab staining: granular deposition of Ig and complement in glomerulus

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Clinical Presentations

Pulmonary Manifestations

• Diffuse Alveolar Hemorrhage (see [[Diffuse Alveolar Hemorrhage]]): rare
  • Symptoms usually present for only days-weeks before presentation
  • Cough
  • Dyspnea
  • Hemoptysis: may be absent on initial presentation, even after significant alveolar hemorrhage
  • Chest pain: may occur

Renal Manifestations

• Glomerulonephritis

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Treatment

• xxx

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References

• xxx