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Pulmonary Renal Syndrome

Definition: Diffuse alveolar hemorrhage + Glomerulonephritis
Presentation (Pulmonary and renal manifestations can occur weeks apart):
Renal Syndromes ... ANCA-positive vasculitis ... ANCA-negative vasculitis ... IgA-associated vasculitis ... #Syndrome #differential
Vasculitis and Vasculitides - Differential Diagnosis Framework

When to Consider Vasculitis:
 • Purpura, ischemic skin lesions
 •
pulmonary and renal ... • Microscopic Polyangiitis ... > PR3 60% • GPA ... mucositis - Rash ... differential #diagnosis
Cryoglobulinemia Summary

Cryoglobulins:
 • Cryoglobulins are Igs in the serum that precipitate in vitro at temperatures below
Syndrome: • Clinical ... - GPA, EGPA, microscopic ... polyangiitis ... • IgA vasculitis ... • Vasculitis
Dermatologic Manifestations of Granulomatosis with Polyangiitis (GPA)

Skin involvement in granulomatosis with polyangiitis (GPA) is common and
vasculitis Skin ... Diagnosis: Vasculitis ... Granulomatous vasculitis ... • Necrotising vasculitis ... #rash #diagnosis
Vasculitis - Differential Diagnosis Framework

When to Consider Vasculitis:
• Purpura, ischemic skin lesions
• Mononeuritis multiplex
• Hematuria, proteinuria,
Vasculitis - Differential ... pulmonary and renal ... Differential Diagnosis ... , mucositis • Rash ... MPO > PR3 60/ GPA
Paraproteinemias

Entities That Can Feature A Monoclonal Protein/M Component:
• MM
• WM
• MGUS
• MGCS
• MGRS
• Splenic Marginal Zone
gangrenosum • Cutaneous ... Autoimmunity: • -MM/WM: Vasculitis ... Hypergammaglobulinemic macular Vasculitis ... to cold IgG • Lupus ... vascular beds-renal
SLE (Systemic Lupus Erythematosus)

Suspect:
Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
vasculitis, rheumatoid ... context of primary immune ... • Mesenteric vasculitis ... APLA/LAC: • Renal ... Vasculitis: •