In layman’s terms, pulmonary renal syndrome (PRS) is a condition that affects both the lungs and kidneys. It is not a disease in and of itself, but a condition that develops as a result of multiple autoimmune diseases, in which the body’s immune system attacks its own tissues and organs. PRS is a medical emergency that requires prompt diagnosis and stringent management in the intensive care unit.
What are the conditions that cause PRS?
The following conditions can lead to pulmonary renal syndrome:
- Connective Tissue Disorders:Systemic lupus erythematosus (a chronic inflammatory condition), Dermatomyositis (a condition in which the skin or muscles become inflamed), and Polymyositis (conditions in which the muscles or skin become inflamed).
- Goodpasture Syndrome:a rare illness that can cause kidney failure and lung disease that gets worse quickly.
- Systemic Vasculitis:Blood vessel inflammation-related diseases include Behçet syndrome, Churg-Strauss syndrome, microscopic polyarteritis, and granulomatosis with polyangiitis.
- Renal DisordersIgA Nephropathy, Rapidly Progressive Glomerulonephritis with Heart Failure, and Idiopathic Immune Complex Glomerulonephritis are a few examples of diseases in which the kidney’s glomerulus—a group of tiny blood vessels at the end of a kidney tubule—is harmed.
What goes wrong?
In pulmonary renal syndrome, the following are the primary areas of affection:
- a)Blood vessels, capillaries and alveoli of the lungThe term “diffuse alveolar hemorrhage” refers to the bleeding that occurs when antibodies attack the blood vessels and capillaries as well as the lung’s alveoli, which are responsible for purifying blood and exchanging gases.
- b)Glomerular apparatusIn focal segmental proliferative glomerulonephritis, which is a condition caused by antibodies attacking the glomerules, which are the kidney’s filtration units, antibodies target the proteins and salts needed by the body and flush out waste products.
What are the signs and symptoms?
The symptoms and signs that reappear signify the malfunction of either the kidneys or the lungs or both, depending on whether the kidneys and the lungs are affected simultaneously or weeks apart. Some of the presenting symptoms include:
- Breathlessness
- Cough
- Fever
- Blood in sputum (hemoptysis)
- Hematuria, or blood in the urine, is indicated by pink or cola-colored urine.
- Proteinuria, a condition in which the urine is foamy,
- High Blood Pressure (hypertension)
- abdomen, hands, feet, or face swelling.
- The causes of fatigue may be anemia or kidney disease.
How is Pulmonary Renal Syndrome diagnosed?
When blood is found in sputum and there are no other known causes, PRS is usually suspected, especially when other kidney-related symptoms are also present.
Following steps are followed to diagnose and assess the extent of pathology:
- Getting the urine tested is the first step; glomerulonephritis is indicated by the presence of red cell casts.
- To evaluate the functioning of the kidneys, serum creatinine is measured.
- Anemia is checked routinely with CBC.
- ANCA (for Granulomatosis with Polyangiitis), ANCA to Myeloperoxidase (for Microscopic Polyangiitis), and antibodies to dsDNA and reduced serum complement levels are just a few examples of the antibodies that can be tested in the blood to determine the underlying disease.
- To confirm the diagnosis of PRS, a tissue sample is taken from the kidney for glomerulonephritis and the lung for findings of small-vessel vasculitis (referred to as the Lung & Kidney Biopsy).
How is PRS treated?
The cornerstone of modern medical treatment is to suppress the immunity in order to control the condition and treat the underlying disease. The most popular drugs used for immunosuppression are corticosteroids and cyclophosphamide. some cases may require plasma exchange. the root cause of PRS is the imbalance in the immunity and the antibodies resulting from the same.
Low dose corticosteroids and cytotoxic agents are administered for an additional 6 to 12 months after the life-threatening condition has subsided, but relapse may still occur despite ongoing treatment.
In addition to conventional medicine, homoeopathy provides supportive care for the treatment of pulmonary renal syndrome.
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