[Rapid progressive glomerulonephritis as a nephrological emergency--case 8/2013]. / Die rapid-progressive Glomerulonephritis als nephrologischer Notfall--Fall 8/2013.

ABSTRACT

HISTORY AND ADMISSION FINDINGS: We report on a 53-year-old female patient who was admitted to hospital with fever, dyspnoea and arthralgias that was followed by diarrhoea and anuria. Upon respiratory deterioration she was referred to our hospital. INVESTIGATIONS Urine analysis revealed an active urine sediment and kidney ultrasound showed hyperechoic renal parenchyma. Chest x-ray revealed widespread bilateral opacifications that were further investigated by bronchoscopy. A renal biopsy was performed due to an active urine sediment. DIAGNOSIS, TREATMENT AND COURSE The patient suffered from pneumonia induced by pulmonary congestion and a newly acquired influenza infection. Histological examination of the kidney biopsy revealed an extracapillary proliferative IgA glomerulonephritis. After stabilization of the pulmonary situation and commencing hemodialysis, immunosuppressive therapy was started including cyclophosphamid. CONCLUSIONS: A rapid-progressive glomerulonephritis represents a nephrological emergency leading to acute kidney injury and dysfunction of other organs.