Malignant Hypertension Mimicking Pulmonary-Renal Syndrome

Pulmonary renal syndrome (PRS) is a rare clinical syndrome characterized by pulmonary hemorrhage and rapidly progressing glomerulonephritis. It is commonly due to a rheumatologic etiology, including antineutrophil cytoplasm antibodies vasculitis or antiglomerular basement membrane disease. Given the rapid progression, patients are often empirically treated when there is high clinical suspicion for PRS. Few case reports have shown malignant hypertension (HTN) as a mimicker of PRS. We present a case of a patient with dyspnea, hemoptysis, and hematuria where there was high suspicion for PRS, and immunosuppression was initiated, but in the end, the etiology was malignant HTN. Malignant HTN can lead to multiple end-organ damage, including the lungs and kidneys; thus, it is important to consider malignant HTN in the differential. Overall, we report a case of malignant HTN mimicking PRS.