PMC8260674_01
Kidney biopsy findings. (A) Light microscopy analysis: Fibrin within glomerular capillary loops (black triangle). Small inter-lobular artery with intimal mucoid alterations and endothelial cells swelling (+). Arteriolar occlusion (*). Polymorphonuclear infiltration with tubulitis (thick arrows) and granular casts (thin arrow) (Jones methanamine silver staining, x200). (B) Immunofluorescence stucy showing predominant mesangial and sub-endothelial C3 deposits in glumeruli and in glomerular arteriole. (Anti-C3c fluorescein isothiocyanate-conjugate x400). (C) Immunochemistry study showing positive C5b-9 staining in arterioles, inter-lobular artery and glomeruli within the mesangium (Mouse IgG, B7 antineoepitope, 1x40). 1Kindly provided by Prof. P. Morgan (Cardiff Intitute of Infection&Immunity, UK).
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A significant interstitial infiltrate, mainly composed of neutrophils, was responsible for severe tubulitis and moderate acute tubular necrosis ( Figure 1A ). IgA, IgM, C1q or C4d deposits ( Figure 1B ). Immunochemistry study showed C5b-9 deposits at the same localisation ( Figure 1C ). Immunological work-up is shown in  Table 2 .