Alveolar hemorrhage associated with a membranoproliferative glomerulonephritis and smooth muscle antibody

Alveolar hemorrhage along with glomerulonephritis developed in a 31-year-old black man. Renal biopsy demonstrated a granular pattern of immunofluorescence along basement membrane glomeruli, suggesting an immunologically mediated illness; however, light microscopy revealed a pure membranoproliferative glomerulonephritis, which has not been described to date in association with the alveolar hemorrhage syndromes. The patient's immunologic profile revealed a positive antinuclear antibody titer along with the presence of smooth muscle antibodies.