D

All four listed conditions are recognized causes of pulmonary-renal syndrome because each can produce diffuse pulmonary haemorrhage together with acute glomerular injury: anti-GBM (Goodpasture) disease [Rankin & Matthay, 1982, PMID 6810558], severe leptospirosis with pulmonary haemorrhage and renal failure [Golubić, 2003, PMID 15011463], hantavirus infection causing hantavirus pulmonary/renal syndrome [Manigold, 2014, PMID 24652684], and Wegener’s (granulomatosis with polyangiitis) with alveolar capillaritis and rapidly progressive glomerulonephritis [Kundu, 2013, PMID 23798092].