PMC5750514_01
Radiograph on day of admission. Radiograph showing dense consolidation of the right lung obscuring the cardiothymic silhouette and tracheal deviation towards the right. Bilateral consolidation with associated air bronchograms.
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Her first chest X-ray showed bilateral consolidations with air bronchograms, consistent with diffuse pulmonary hemorrhage (Figure 1).
Renal biopsy. (a) Acute diffuse proliferative glomerulonephritis with intracapillary neutrophils and closure of glomerular capillaries and infiltration of capillaries. (b) and (c) Portion of glomerus shows intracapillary inflammatory cells, swelling of endothelial cells, mesangium, and subendothelial and (d) rare subepithelial dense deposits.
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A renal biopsy was performed which demonstrated enlarged glomeruli with diffuse endocapillary hypercellularity with numerous neutrophils and closure of glomerular capillaries (Figure 2).
Follow-up radiograph. Improvement in pulmonary disease from previous image five days following admission and treatment. Mild perihilar consolidation persists with basal atelectasis.
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Her chest X-ray improved greatly by day 5 in hospital (Figure 3) and she was successfully weaned off HFOV and CRRT.