Pulmonary renal syndrome due to atypical presentation of IgA nephropathy associated with anca positive vasculitis

Abstract

IgA nephropathy (IgN) ranges from asymptomatic hematuria to rapidly progressive glomerulonephritis (RPGN). The lung-kidney syndrome involves diffuse alveolar hemorrhage and GNRP and may be caused by IgA vasculitis. Rare cases associate NIgA with ANCA vasculitis. We report a 35-year-old patient who presented with GNRP, with a previous renal biopsy compatible with NIgA. After an initial response, she presented with renal relapse and alveolar hemorrhage. She was diagnosed with NIgA associated with ANCA vasculitis. Her condition improved, but she is on chronic dialysis therapy. The occurrence of IgA nephropathy and positive ANCA is quite uncommon, with prognostic and therapeutic implications.