Recurrent diffuse pulmonary hemorrhage with minor kidney lesions.

This case report concerns a 14-year-old boy with a 3 month history of dyspnea and iron deficiency anemia. On admission he had hemoptysis and bilateral pulmonary shadows. Transbronchial lung biopsies showed linear deposits of IgG and C3 in the alveolar basement membrane, but no anti-GBM antibodies were observed in serum or kidney biopsy. The ratio of the T cell subpopulations T4/T8 in peripheral blood was in the early stage, 5 and, thus, elevated. The patient was given prednisolone 1 to 0.25 mg/kg and cyclophosphamide 2 mg/kg with temporary cessation of pulmonary bleeding. Hemoptysis recurred and plasma exchange was performed with success.