The pulmonary-renal syndrome.

The pulmonary-renal syndrome is characterized by the coexistence of life-threatening pulmonary hemorrhage and renal disease in individuals without any concomitant destructive pulmonary disease or coagulopathy. Six patients fulfilled the above criteria despite diverse etiologies and pathomechanisms of disease. Two patients showed evidence of anti-glomerular basement membrane antibodies, while three others showed immune complexes in their kidneys. Therefore, it is likely that immunologic events play an important pathogenic role in this syndrome, explaining the effectiveness of nephrectomy as demonstrated in these patients. The chest radiograph was a reliable indicator of the extent of the pulmonary hemorrhage and was representative of the clinical presentation and blood gas levels. During the recovery phase the radiographic findings lagged somewhat behind the clinical improvement in the gas exchange.