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1、IgA腎病、惡性高血壓與肺出血1IgA腎病與肺出血2Pulmonarycapillaritisandalveolarhemorrhage.Updateondiagnosisandmanagement.Pulmonaryvascularinflammatorydisordersmayinvolveallcomponentsofthepulmonaryvasculature,includingcapillaries.Theprincipalhistopathologicfeaturesofpulmonarycapillaritisincl
2、udecapillarywallnecrosiswithinfiltrationbyneutrophils,interstitialerythrocytes,and/orhemosiderin,andinteralveolarseptalcapillaryocclusionbyfibrinthrombi.Immunecomplexdepositionisvariablypresent.Patientsoftenpresentclinicallywithdiffusealveolarhemorrhage,whichischaracter
3、izedbydyspneaandhemoptysis;diffuse,bilateral,alveolarinfiltratesonchestradiograph;andanemia.PulmonarycapillaritishasbeenreportedwithvariablefrequencyandseverityasamanifestationofWegener'sgranulomatosis,microscopicpolyarteritis,systemiclupuserythematosus,Goodpasture'ssyn
4、drome,idiopathicpulmonaryrenalsyndrome,Behcet'ssyndrome,Henoch-Schonleinpurpura,IgAnephropathy,antiphospholipidsyndrome,progressivesystemicsclerosis,anddiphenylhydantoinuse.3Aclinicopathologicstudyof34casesofdiffusepulmonaryhemorrhagewithlungbiopsyconfirmation.34patient
5、swithbiopsy-confirmeddiffusepulmonaryhemorrhage(DPH).DPHsyndromeswereencountered:antibasementmembraneantibodydisease(fourcases);idiopathicpulmonaryhemorrhage(fourcases);WG(fivecases);probableWG(sixcases);systemicnecrotizingvasculitisotherwiseunclassified(threecases);sys
6、temiclupuserythematosus(twocases);rheumatoidarthritis(onecase);seronegativejuvenilerheumatoidarthritis(onecase);IgAnephropathy(onecase);idiopathicglomerulonephritis(twocases--onewithandonewithoutimmunecomplexes);andunclassifiedpulmonary-renalsyndromes(fivecases).Capilla
7、ritiswasfoundinlungbiopsysamplesfrom30ofthe34patients(88%)andincludedpatientswitheverytypeofDPHsyndrome.AmJSurgPathol.1990Dec;14(12):1112-25.4Pulmonaryhemorrhage.AfatalmanifestationinIgAnephropathy.TwopatientswithasymptomaticIgAnephropathy(IgAN)andathirdpatientwithchron
8、icrenalfailureduetoIgANdiedfollowingarecentonsetofdyspnea,hemoptysis,andpulmonaryinfiltrates.Inallcases,thecau
