Abstract：
A man in his early 30s presented with sudden-onset respiratory distress, haemoptysis and reduced urine output. He was in volume overload with a blood pressure recording of 240/180 mm Hg. Pulmonary renal syndrome was suspected and he was initiated on plasmapheresis, followed by steroid pulse therapy. Chest radiography and the presence of fragmented red cells on the peripheral smear were unexplained. These were later explained by hypertensive nephropathy and thrombotic microangiopathy changes on renal biopsy. His respiratory and haematological parameters improved with blood pressure control. Malignant hypertension closely resembles pulmonary renal syndrome, which must be remembered in order to avoid plasmapheresis and high-dose immunosuppressive therapy.
摘要：
一名30多岁的男子突然出现呼吸窘迫，咯血和尿量减少。他的容量超负荷，血压记录为240/180mmHg。怀疑是肺肾综合征，并开始进行血浆置换，然后是类固醇脉冲疗法.胸部X线照相术和周围涂片上破碎的红细胞的存在是无法解释的。这些后来被解释为高血压肾病和血栓性微血管病变在肾活检中的变化。他的呼吸和血液学参数随着血压控制而改善。恶性高血压与肺肾综合征非常相似，必须记住，以避免血浆置换和大剂量免疫抑制治疗。
