Pulmonary hemorrhage with acute renal injury in a patient with IgA nephropathy

IgA nephropathy (IgAN) is a form of glomerular diseases which is usually aggravated by infection in respiratory or gastrointestinal systems. The clinical manifestations in IgAN can be asymptomatic microscopic hematuria, gross hematuria, nephritic syndrome, nephrotic syndrome or acute renal injury from crescentic glomerulonephritis. Acute interstitial nephritis (AIN) has been previously described as an unusual cause of acute renal injury in IgAN. Hemoptysis from diffuse pulmonary hemorrhage is a rare manifestation in IgAN. We reported a patient who presented with fever hemoptysis from diffuse pulmonary hemorrhage, and acute renal injury. Renal biopsy revealed IgAN concomitant with AIN which was the cause of renal dysfunction. We conclude that pulmonary hemorrhage and acute interstitial nephritis can be found in IgAN. The etiology of pulmonary hemorrhage and acute interstitial nephritis might be from infection. Renal biopsy is a mandatory investigation to make the correct diagnosis.