PMC5165133_01
Findings on chest radiography and computed tomography. (a) Chest radiograph showing reticular shadows in the right middle and lower lung fields (arrow). Calcified lesions were seen in the left lung field (arrowhead). (b-e) Chest computed tomography (CT) showing segmental ground glass shadows in the upper and lower lobes of the right lung (arrow). The left pleura shows thickening with calcification (arrowhead).
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In addition, a calcified lesion was observed in the left middle part (Figure 1(a)). Chest computed tomography (CT) showed a ground glass shadow and consolidation in the right upper and lower lobes with left sided pleural thickening and calcification (Figures 1(b)-1(e)).
Pathological findings of the renal biopsy specimen. Cellular crescent formations (arrow) and lobulation were observed in the glomeruli (arrowhead) by (a) Haematoxylin and Eosin stain (x400) and (b) Periodic acid-Schiff stain (x400).
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Renal biopsy was performed and pathological evaluation of the specimen revealed cellular crescent formations and lobulation in more than half the glomeruli (Figure 2).
Clinical course of the MPA patient. Serial chest radiographs showed the clinical course of the pulmonary shadows in the right middle and lower lung fields. The solid line in the graph shows serum creatinine levels and the dashed line shows haemoglobin levels during the patient's clinical course. Tx: treatment.
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We initially planned to treat her with corticosteroids and intravenous cyclophosphamide (IVCY), and, therefore, we first started treatment with corticosteroid therapy (prednisolone 50 mg/day) (Figure 3).