Malignant Hypertension with Pulmonary Alveolar Hemorrhage Needing Dialysis

Although blood pressure rises with age, it has been recognized that some individuals develop rapidly progressive blood pressure elevations with target organ injury. If these blood pressure elevations are not treated, the mortality rate in patients with target organ injury, including papilledema and declining kidney function, can exceed 50% over 6–12 months, and this hypertension is considered ‘malignant’ [1]. Malignant hypertension is histologically characterized by fibrinoid necrosis of arterioles and progresses rapidly. It is observed in a variety of organs, including the kidneys, pancreas, gastrointestinal tract, liver, retina, brain, myocardium, prostate, and skeletal muscles. However, pulmonary hemorrhage is rare. Here, we report a rare case of malignant hypertension with pulmonary alveolar hemorrhage. Case