肺出血を合併した特発性急速進行性糸球体腎炎の1剖検例

Abstract

A 50-year-old female was admitted with complaints of dyspnea and hemoptysis, and died of respiratory failure with massive pulmonary hemorrhage on the 13th hospital day. Autopsy examination showed widespread intra-alveolar hemorrhage in both lungs and diffuse crescentic glomerulonephritis in the kidneys. Immuno-fluorescence studies of lung and kidney tissue revealed no immuno-reactant deposition. Circulating anti-glomerular basement membrane (anti-GBM) antibody was not detected by radioimmunoassay. This report represents a case of diffuse alveolar hemorrhage with idiopathic rapidly progressive glomerulonephritis from an immuno-pathological viewpoint. It emphasizes that pulmonary hemorrhage with glomerulonephritis occurs in a variety of situations which are not mediated by anti-GBM antibody or immune complex.