Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a constellation of pulmonary-renal syndrome, reporting progressive dyspnea, dry cough, and episodes of hemoptysis. Associated symptoms include hematuria, oliguria, and systemic malaise. No history of recent upper respiratory infection or exposure to toxins.
Clinical Examination Findings
General: Patient appears pale and tachypneic. HEENT: Conjunctival pallor noted. Respiratory: Bilateral fine crackles on auscultation, decreased breath sounds at bases. Cardiovascular: Tachycardia, no murmurs. Abdominal: Mild suprapubic tenderness. Extremities: Bilateral pitting edema (1+). Skin: No purpura or vasculitic rashes.
Treatment Protocol
Immediate initiation of plasmapheresis to remove circulating anti-GBM antibodies. High-dose intravenous pulse methylprednisolone followed by oral prednisone taper. Cyclophosphamide therapy initiated for immunosuppression. Close monitoring of renal function (Cr, BUN) and pulmonary status (SpO2, serial CXR).