Pulmonary-renal syndrome Pulmonary-renal syndrome is a rare disease that develops against the backdrop of a major autoimmune disease. Most often combines the symptoms of glomerulonephritis and diffuse alveolar bleeding of the lungs.


It may be caused by:

  • Wegener's granulomatosis;
  • by polyangiitis;
  • systemic lupus erythematosus;
  • Goodpasture syndrome;
  • with lgA-neuropathy;
  • heart failure;
  • chronic diseases of connective tissue, kidneys and organs of the genitourinary system;
  • by Behcet's syndrome;
  • by dermatomyositis;
  • with purple Shenlaine-Genocha;
  • with glomerulonephritis;
  • mixed cryoglobulinemia;
  • by rheumatoid arthritis;
  • by other autoimmune diseases.

Forms of pulmonary-kidney syndrome

Given the rate of disease progression, there are 2 forms of pulmonary-renal syndrome:

  • violent( symptoms of renal failure, high mortality for 1 year);
  • delayed( there is a periodic progression of the disease, an increase in life expectancy up to 12 years).

Causes of the disease

Causes of the disease to date have been studied insufficiently. Most often, its occurrence is associated with viral infections, especially during the epidemics of new strains of influenza, ARI.

There are data that confirm that pulmonary-kidney syndrome occurs in persons in contact with volatile hydrocarbons, organic solvents, paints.

Also, the disease can be caused by the intake of certain drugs, on the composition of which the body produces organospecific antibodies. Now about 100 drugs are known, the use of which contributes to the onset and further progression of pulmonary-kidney syndrome.

To all this, many environmental factors can cause the formation of immune complexes that precipitate on the walls of the vessels and lead to an inflammatory process of small vessels of the lungs and kidneys.

The most common causes of the onset and further development of the disease are:

  • bacterial and viral infections;
  • taking medications that reduce the defense of the immune system;
  • oncology;
  • external chemical and physical factors( vapors of gases, solvents, paints);
  • use of narcotic drugs;
  • AIDS;
  • is a natural autoimmune reaction of the body( when the body produces antibodies directed to the destruction of the kidneys and lungs, considering their cells to be foreign).

Symptoms of the disease

The disease is very fast symptomatology. Among the main signs of the disease are:

  • increase in blood pressure;
  • anemia;
  • swelling of the abdomen, legs, face;
  • overall fatigue;
  • sharp weight loss;
  • temperature and chills;
  • Inflammation of the eye;
  • severe chest pain;
  • wet cough, accompanied by expectoration against a background of bilateral inflammation of the kidneys;
  • frequent dyspnea;
  • decrease in the amount of a single portion of urine;
  • change the color of urine to a brown color with an admixture of blood.

A lung disease usually occurs earlier than the kidneys. Patients with periodic dyspnea, then a week later manifested cough with expectorant sputum. This indicates pulmonary bleeding and damage to the patient's airway. In addition to this, against the background of respiratory failure glomerulonephritis develops, which very rapidly progresses and leads to kidney failure.

At the last stage of the disease progression, patients experience general malaise, weakness, fever, arterial hypertension.

Diagnosis

A comprehensive diagnosis is possible to diagnose the disease correctly and on time, including:

  • compiling a medical history;
  • a survey of chronic illnesses and bad habits;
  • study of genetic predisposition;
  • results of blood tests( general, biochemical), urine and expectorant sputum;
  • control of breathing dynamics;
  • ultrasound of the lungs and kidneys;
  • study of tissue samples by the method of immunofluorescent reaction;
  • consultation phthisiatrician, pulmonologist, therapist.

Usually urinalysis allows you to determine the most accurate disease, to clarify the stage of the disease, to investigate the work of the kidneys.

Using pulmonary ultrasound, it is easy to detect pulmonary hemorrhage due to an increase in the volume of carbon monoxide.

Methods of treatment of pulmonary-renal syndrome

At the initial stages of the disease, patients are prescribed active 2-week immunosuppressive therapy( immunosuppressants and corticosteroids in high doses) and a special diet for correction of kidney function. After that, good results are given by daily plasmapheresis, and if the kidneys are disturbed - hemodialysis.

In some cases, symptomatic therapy is recommended, the essence of which is the frequent transfusion of blood and the restoration of it in the body with iron-containing drugs.

Drugs in the treatment of pulmonary-kidney syndrome do not give very good results, however, to facilitate the symptoms of the disease, patients are prescribed methylprednisolone intravenously for 1 month in the early stages of the disease and 12 months in severe forms.

In severe forms of the disease, surgical treatment is performed, which consists in kidney transplantation. If, before the surgical intervention in the blood, antibodies destroying the kidney cells were not detected, there is no recurrence of the progression of the disease, and the patient can go on to the amendment.

In all other cases, the prognosis is unfavorable, especially when the disease is started or there are signs of kidney failure even before the treatment.

Category of people at risk of

Men in the age group under 40 years are most likely to become infected, people who are genetically predisposed to the disease, constantly in contact with toxic substances, external physical and chemical factors.

Complications of pulmonary-renal syndrome

To date, existing therapies do not completely cure pulmonary-kidney syndrome and prevent the dynamics of its progression.

In most cases, the prognosis of the disease is disappointing.

Rapidly developing kidney failure in a very short period of time leads to the cessation of kidney function. Pulmonary bleeding complicates respiratory function, which, in the final analysis, leads to death.

Regardless of the stage of the disease, pulmonary-kidney syndrome occurs with severe symptoms, constantly progressing, causing severe forms of pulmonary and renal failure.

The lifespan of patients ranges from several months to 1-5 years. Very often, the lethal outcome of patients comes from open pulmonary hemorrhage or uremia.

Prevention of

Disease You can protect yourself from a serious illness by leading a healthy lifestyle, assuming:

  • refusal from smoking and alcohol abuse;
  • prevention and timely treatment of infectious and colds;
  • sports;
  • walking in the fresh air;
  • hardening;
  • timely access for qualified medical care at the first sign of illness.