Mohandes Samer, Satoskar Anjali, Hebert Lee, Ayoub Isabelle
Clin Nephrol. 2018 Dec;90(6):431-433. doi: 10.5414/CN109495.
The etiology of pulmonary renal syndrome can be broadly divided into infectious and autoimmune (predominantly ANCA vasculitis). The importance of timely differentiating between them stems from the deleterious effects of their respective treatment if misdiagnosed. Serology and tissue evaluation by pathology are employed to aid in this, however, in rare cases, this can be difficult. We present a case of infectious endocarditis that presented with pulmonary renal syndrome but had positive ANCA serology and a pauci-immune glomerulonephritis picture on kidney biopsy that posed diagnostic difficulty. Factors most helpful in differentiating between the two conditions are highlighted as well as treatment options. .
肺肾综合征的病因大致可分为感染性和自身免疫性（主要是抗中性粒细胞胞浆抗体相关性血管炎）。及时区分它们的重要性源于如果误诊，各自治疗会产生有害影响。血清学检查和病理组织评估有助于鉴别诊断，然而，在罕见情况下，这可能会很困难。我们报告一例感染性心内膜炎病例，该病例表现为肺肾综合征，但抗中性粒细胞胞浆抗体血清学检查呈阳性，肾活检显示寡免疫性肾小球肾炎表现，这给诊断带来了困难。文中强调了对这两种情况进行鉴别最有帮助的因素以及治疗选择。
