Hemoptizi ve Akut Böbrek Hasarı Birlikteliğinde Kritik Tanı: Pulmoner-Renal Sendrom Olgu Sunumu
Özet
Pulmoner renal sendrom (PRS), diffüz alveolar hemoraji ve hızla ilerleyen glomerülonefrit ile karakterize, acil tanı ve tedavi gerektiren nadir bir klinik durumdur. Bu olgu sunumunda,25 yaşında kadın hastanın anti-glomerüler bazal membran (anti-GBM) hastalığına bağlı PRS tanısı ve tedavi süreci sunulmaktadır. Hasta, kanlı idrar, hemoptizi ve yorgunluk şikayetleriyle başvurmuş, yapılan tetkikler sonucunda akut böbrek hasarı (ABH) ve anti-GBM pozitifliği saptanmıştır. Böbrek biyopsisinde kresentik glomerülonefrit ve immünofloresan incelemede lineer IgG depolanması görülmüştür. Hasta, plazmaferez, hemodiyaliz ve yüksek doz steroid tedavisi ile başarılı şekilde tedavi edilmiştir. Bu olgu, PRS’de erken tanı ve agresif tedavinin hayat kurtarıcı önemini vurgulamaktadır. Klinik şüphe, hızlı tanısal yaklaşım ve multidisipliner tedavi, prognozu belirleyen en önemli faktörlerdir.
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