Diffuse alveolar hemorrhage syndrome after renal transplantation:one case report and literature review / 器官移植

Objective To analyze and summarize clinical characteristics and treatment of diffuse alveolar hemorrhage syndrome (DAHS)complication after renal transplantation.Methods Clinical data of one patient,admitted to the 309 th Hospital of People's Liberation Army in December 201 2, who was complicated with DAHS after renal transplantation,were obtained.The incidence,diagnosis and treatment courses of DAHS were retrospectively analyzed.Literature review was conducted to summarize clinical experience.Results The patient was clinically manifested with respiratory failure,progressive aggravation of hemoptysis and anemia.Imaging examination revealed that diffusive infiltration of bilateral lungs was aggravated.After the diagnosis of DAHS was confirmed,adrenal cortical hormone (hormone)shock and anti-infectious medication therapies were timely delivered to actively prevent and treat relevant complications.The patient was successfully healed.Until the submission date,the patient presented with normal renal function and no pulmonary complications were noted.Conclusions DAHS is a rare and fatal complication after renal transplantation.Early diagnosis, active anti-infection therapy and timely administration of large-dose hormone shock treatment determine the success of clinical treatment.

Two Cases of Microscopic Polyangiitis / 결핵

Microscopic polyangiitis is a systemic small-vessel vasculitis that is primarily associated with necrotizing glomerulonephritis and pulmonary capillaritis. Lung involvement is characterized by a diffuse alveolar hemorrhage. However, rarely central nervous system involvement has been reported to be occurred with the microscopic polyangiitis. Relapse of microscopic polyangiitis are reported to be more frequent than those of polyarteritis nodosa, often after a reduction or discontinuation of the therapy. We would like to report two patients with microscopic polyangiitis. One presented with clinical manifestations of both lung and central nervous system involvements and the other was a case of recurrence during steroid tapering following the steroid pulse therapy.