A case of a pulmonary-renal syndrome caused by streptococcal infection

Respirol Case Rep. 2023 Jan 10;11(2):e01083. doi: 10.1002/rcr2.1083. eCollection 2023 Feb.


Pulmonary-renal syndrome (PRS) is defined as a combination of diffuse alveolar haemorrhage and glomerulonephritis. An 18-year-old woman visited our hospital with a 2-day history of fever, dyspnoea, and leg edema. Laboratory investigations revealed an elevated inflammatory reaction, increased serum creatinine levels, and normocytic anaemia. Additionally, the anti-streptolysin-O titre was positive, and complement component-3 levels were decreased. Urinalysis revealed proteinuria and hematuria. Bronchoalveolar lavage aliquots were progressively more hemorrhagic. These findings supported a diagnosis of PRS secondary to streptococcal infection. The patient was treated with high-dose methylprednisolone and antibiotics. After 4 days of treatment, her respiratory symptoms and serum creatinine levels improved. Steroid tapering was performed over 15 days. The findings in this case indicate that streptococcal infection is a potential cause of PRS, and that short-term steroid therapy is an effective treatment.

Keywords: diffuse alveolar haemorrhage; methylprednisolone; post‐streptococcal glomerulonephritis; pulmonary‐renal syndrome; streptococcal infection.

Publication types

  • Case Reports