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Pulmonary Renal Syndrome

Definition: Diffuse alveolar hemorrhage + Glomerulonephritis
Presentation (Pulmonary and renal manifestations can occur weeks apart):
Differential Diagnosis ... ANCA-positive vasculitis (Eosinophilic ... allopurinol), Infection ... high resolution chest ... CT • Bronchoscopy
Feeding Vessel Sign on Chest CT
 • Distinct pulmonary vessel leading into a lung nodule or
CT • Distinct ... pulmonary vessel ... #Vessel #Sign #CT ... #diagnosis #radiology ... #clinical
Halo Sign on Chest CT
 • SPN or mass surrounded by a circumferential GGO
 • DDx:
CT • SPN or mass ... #Halo #Sign #CT ... #Lung #Pulmonary ... #diagnosis #radiology ... #clinical
Pulmonary Renal Syndromes - OnePager Summary
Autoimmune ANCA vasculitis (AAV): GPA (granulomatous with polyangiitis), EGPA (eosinophilic granulomatosis
polyangiitis), EGPA (eosinophilic ... differential (check eosinophil ... Other tests: • CT ... confirm DAH, r/o infection ... CT
On the left a patient who had a CT to rule out pulmonary embolism.
There is a
patient who had a CT ... to rule out pulmonary ... The diagnosis based ... #Clinical #Radiology ... #CTChest #SeptalThickening
Miliary Pattern - Chest Radiology
 • Miliary opacities are scattered, small (1 -4 mm) nodules
 •
Differential Diagnosis ... Opacities: • Infectious ... #diagnosis #pulmonary ... #CXR #clinical ... #CT
Etiologies of pulmonary infections according to CT-scan patterns. 
CMV cytomegalovirus, GM galactomannan, HSV herpes simplex virus,
Etiologies of pulmonary ... infections according ... myelodysplastic syndrome ... #Differential #Diagnosis ... #Chest
Myocarditis
Diagnosis 
• Endomyocardial biopsy (gold standard, rarely performed) 
• Clinical presentation 
• Cardiovascular MRI 
Clinical 
•
Myocarditis Diagnosis ... Cardiovascular MRI ... intolerance • Chest ... IVIG (Giant cell, eosinophilic ... #Management #Cardiology
High-Res Chest CT Patterns - Differential Diagnosis Framework
Reticular:
 • Septal Thickening: Lymphangitic Carcinoma, Interstitial Edema, Alveolar
High-Res Chest CT ... - Differential Diagnosis ... #CT #Patterns # ... Differential #Diagnosis ... #pulmonary #radiology
Restrictive Cardiomyopathy - Diagnosis and Causes
Clinical: Dyspnea, Exercise Intolerance, ↑ "Right Sided-Symptoms" (ascites, hepatomegaly, ↑↑peripheral edema)
Physical
and Causes Clinical ... Echocardiography, Cardiac MRI ... Fibrosis, Hyper-eosinophilc ... Syndrome, Endocardial ... #differential #cardiology