++
++
Idiopathic recurrent alveolar hemorrhage and rapidly progressive glomerulonephritis
Mediated by anti-glomerular basement membrane antibodies
Occurs mainly in men who are in their 30s and 40s
++
Hemoptysis is the usual presenting symptom
However, pulmonary hemorrhage may be occult
Dyspnea, cough, hypoxemia, and diffuse bilateral alveolar infiltrates are typical features
Iron deficiency anemia and microscopic hematuria are usually present
++
++
Combinations of immunosuppressive drugs (initially methylprednisolone, 30 mg/kg intravenously over 20 minutes every other day for three doses, followed by daily oral prednisone, 1 mg/kg/day; with cyclophosphamide, 2 mg/kg by mouth per day) and plasmapheresis have yielded excellent results