Rajkumar Theepika, Vilayur Eswari
Nephrology and Transplantation Unit, John Hunter Hospital, Newcastle, New South Wales, Australia.
BMJ Case Rep. 2018 Jan 4;2018:bcr-2017-222717. doi: 10.1136/bcr-2017-222717.
We describe a patient with untreated hepatitis C virus (HCV) infection presenting with pulmonary renal syndrome. He rapidly developed bilateral lung infiltrates and respiratory failure, and bronchoscopy confirmed acute alveolar haemorrhage secondary to cryoglobulinaemic vasculitis. Early bronchoscopy to confirm the diagnosis and consequent institution of immunosuppressive therapy led to excellent outcomes, which otherwise is reported in the literature to carry significant mortality. Therefore, in patients with HCV presenting with bilateral lung infiltrates, physicians must maintain a high degree of clinical suspicion for alveolar haemorrhage secondary to cryoglobulinaemic vasculitis.
我们描述了一名患有未经治疗的丙型肝炎病毒（HCV）感染且出现肺肾综合征的患者。他迅速出现双侧肺部浸润和呼吸衰竭，支气管镜检查证实为冷球蛋白血症性血管炎继发的急性肺泡出血。早期进行支气管镜检查以确诊并随后实施免疫抑制治疗带来了极佳的治疗效果，而在文献报道中，否则该病症具有较高的死亡率。因此，对于出现双侧肺部浸润的HCV患者，医生必须对冷球蛋白血症性血管炎继发的肺泡出血保持高度的临床怀疑。
