Antiglomerular basement membrane disease

Antiglomerular basement membrane (anti-GBM) disease may present as rapidly progressive glomerulonephritis alone, or in the presence of a secondary pulmonary insult (e.g. smoking or other toxicity, or infection) in combination with lung haemorrhage. Rarely it presents as lung disease alone (with haematuria) or as subacute glomerulonephritis. The major differential diagnoses are small vessel vasculitis, which is a more common cause of pulmonary haemorrhage with rapidly progressive glomerulonephritis, and causes of simultaneous pulmonary and renal failure. For most of these, the lung lesion is not pulmonary haemorrhage. The diagnosis often most quickly, most sensitively, specifically and usefully made by renal biopsy, but immunoassays showing a high titre of anti-GBM antibodies in the setting of severe renal disease are also useful. Borderline and even normal anti-GBM titres are not so specific or reliable in some forms of the disease though.

Antiglomerular basement membrane disease

Antiglomerular basement membrane disease is characteristically the most rapidly progressive (crescentic) nephritis. It is often accompanied by lung haemorrhage, and occasionally causes lung disease alone. Its hallmark is linear deposition of immunoglobulin G along the glomerular basement membrane. There are usually few systemic symptoms apart from any related to the lung disease. Urine shows haematuria, often macroscopic in very acute disease.

Theoretical Modelling of Alveolar Resonance Mechanism of Ultrasound-Induced Lung Haemorrhage

The possibility of the ultrasound-induced lung haemorrhage occurring in adult human during diagnostic ultrasound examination is studied here. This study is based on the hypothetical alveolar resonance mechanism of the ultrasound-induced lung haemorrhage. The alveolar wall is initially modelled here as a square membrane with fixed-boundary, and then theoretically subjected to vibration analysis. The equation of threshold pressure for the occurrence of ultrasound-induced lung haemorrhage is derived. A comparison test against past experimental data validates the use of the square membrane model of the alveolar wall in studying the ultrasound induced lung haemorrhage. This study predicts that the ultrasound-induced lung haemorrhage in adult human can be prevented if the ultrasound frequency is kept above 1.69 MHz while the Mechanical Index does not exceed 1.9.

-Lung hemorrhage in a green iguana (Iguana iguana) with chronic metabolic failure: a case report

A six year old male iguana (Iguana iguana) was brought to our clinic after a fall from a height of 1.5 meters. The patient showed apathy, dehydration, and paresis of all the limbs. Postural reflexes, palpebral reflex, and response to painful stimuli were minimal. The patient had extremely high levels of uric acid (1 734.0 µmol/l) and phosphorus (9.80 mmol/l), ratio of calcium to phosphorus (0.18), leucocytosis (23.3×10⁹/l) with heterophilia (17.10×10⁹/l), and high activity of ALT, AST and CK (2.09, 6.59, and 260.0 µkat/l). Tracheoscopy and pneumoscopy revealed presence of blood clots in the trachea and lungs with haemorrhage within the parenchyma. Based on the results of the clinical examination, endoscopy and laboratory diagnostics, the clinical diagnosis was chronic kidney failure, liver lipidosis and lung haemorrhage. Because of a very poor prognosis, the patient was euthanised. At necropsy, the signs of visceral gout and hepatomegaly with diffuse yellowish white discoloration and with dotted brown pigmentation were also observed. The kidneys were enlarged, and stained brown grayish. The gross and histopathological examination confirmed the clinical diagnosis of visceral gout, chronic kidney failure, liver steatosis and granulomatous pneumonia, with lung haemorrhage associated with urate deposits in lung tissue and posttraumatic status.