PMC5903134_01
Multiple small granular lesions (arrow) in the lungs on computed tomography before (a) and after treatment (b).
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F1
In addition, she had multiple small granular lesions in the lungs appearing like miliary tuberculosis (TB) on computed tomography (Fig. 1a). Furthermore, her lung disease disappeared after immunosuppressive therapy (Fig. 1b).
Kidney biopsy specimen. a Periodic acid-Schiff-methenamine silver of the glomeruli showing massive wire loop lesions (arrow). b IgG of immunofluorescence staining showing positive staining of the glomerular tuft mesangial and partial endothelium area for IgG. c Electron microscopy of the glomeruli showing massive electron-dense deposits (arrow). d Electron microscopy of the peritubular capillaries showing electron-dense deposits (arrow).
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F2
The kidney biopsy results are shown in Figure 2. The wire loop lesions were more conspicuous than endocapillary proliferation (Fig. 2a). Immunofluorescence staining demonstrated positive staining of the glomerular tuft, mesangial area, and part of the endothelial area for IgG, IgA, IgM, C3, C1q, and fibrinogen (Fig. 2b). On electron microscopy, the glomeruli revealed massive electron-dense deposits in the endothelial and mesangial areas, but no noticeable subepithelial deposition (Fig. 2c). In addition, electron-dense deposit was present in the peritubular capillaries, but not in the tubulointerstitial area or arteries (Fig. 2d).