Lee Shannon M, Martinez Aida F, Yee Nathan
Department of Internal Medicine, Harbor University of California Los Angeles Medical Center, Torrance, USA.
Department of Pulmonary and Critical Care, Harbor University of California Los Angeles Medical Center, Torrance, USA.
Cureus. 2025 Mar 16;17(3):e80654. doi: 10.7759/cureus.80654. eCollection 2025 Mar.
Pulmonary renal syndrome (PRS) is a rare clinical syndrome characterized by pulmonary hemorrhage and rapidly progressing glomerulonephritis. It is commonly due to a rheumatologic etiology, including antineutrophil cytoplasm antibodies vasculitis or antiglomerular basement membrane disease. Given the rapid progression, patients are often empirically treated when there is high clinical suspicion for PRS. Few case reports have shown malignant hypertension (HTN) as a mimicker of PRS. We present a case of a patient with dyspnea, hemoptysis, and hematuria where there was high suspicion for PRS, and immunosuppression was initiated, but in the end, the etiology was malignant HTN. Malignant HTN can lead to multiple end-organ damage, including the lungs and kidneys; thus, it is important to consider malignant HTN in the differential. Overall, we report a case of malignant HTN mimicking PRS.
肺肾综合征（PRS）是一种罕见的临床综合征，其特征为肺出血和快速进展的肾小球肾炎。它通常由风湿性病因引起，包括抗中性粒细胞胞浆抗体血管炎或抗肾小球基底膜病。鉴于其快速进展，当临床高度怀疑PRS时，患者通常会接受经验性治疗。很少有病例报告显示恶性高血压（HTN）可模拟PRS。我们报告一例患者，有呼吸困难、咯血和血尿，高度怀疑为PRS，并开始了免疫抑制治疗，但最终病因是恶性HTN。恶性HTN可导致包括肺和肾在内的多个终末器官损害；因此，在鉴别诊断中考虑恶性HTN很重要。总体而言，我们报告一例模拟PRS的恶性HTN病例。
