Renal vein thrombosis and the nephrotic syndrome.

INTRODUCTION T HERE ARE A VARIETY OF CLINICAL CIRcumstances in which the respiratory and renal systems are simultaneously involved. Periarteritis, lupus erythematosus, sderoderma, and dermatomyositis may involve the lung and kidney; however, they initially do not present with acute pulmonary-renal manifestations, and multisystem involvement is present to suggest the diagnosis. Consideration of this broad problem would have limited clinical value, but the differential diagnosis of the patient who initially presented with predominant pulmonary manifestations soon followed by severe renal involvement delimits the diagnostic possibilities. Case examples of renal vein thrombosis, Wegener’s granulomatosis, Goodpasture’s syndrome, hemolytic streptococcal pneumonia with glomerulonephritis, and pneumococcal pneumonia with renal failure are presented to illustrate this important problem.