# Malignant Hypertension Mimicking Pulmonary-Renal Syndrome

## TL;DR

A patient with symptoms resembling a rare lung-kidney syndrome was actually suffering from severe high blood pressure, highlighting the need to consider this condition in similar cases.

## Contribution

This case report highlights malignant hypertension as a rare mimic of pulmonary-renal syndrome.

## Key findings

- The patient presented with symptoms suggesting pulmonary-renal syndrome but was ultimately diagnosed with malignant hypertension.
- Malignant hypertension can cause lung and kidney damage, mimicking the signs of pulmonary-renal syndrome.
- Early recognition of malignant hypertension is crucial to avoid unnecessary immunosuppressive treatment.

## Abstract

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.