PMC4676346_01
Right pleural effusion with associated basilar atelctasis.
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F1
Chest X-ray done in the ED revealed right pleural effusion, which was confirmed by CT scan (Fig. 1, 2).
Moderate right pleural effusion.
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F2
Chest X-ray done in the ED revealed right pleural effusion, which was confirmed by CT scan (Fig. 1, 2).
Kidney function during hospitalization. This graph demonstrates the progressive rise in BUN and creatinine during hospitalization until a peak of 10.2 where hemodialysis was started.
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F3
Meanwhile, the patient's kidney function continued to deteriorate with an increase in serum creatinine to 5.31 on day 7 despite adequate medical management (Fig. 3).
LM - macrophage infiltration.
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F4
Results came back as diffuse endocapillary proliferative and exudative glomerulonephritis with infiltrating monocytes/macrophages 3+ and neutrophils 1+ on light microscopy (Fig. 4).
EM - subendothelial deposits.
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F5
Electron microscopy revealed global subendothelial electron dense deposits consisting of mixed cryoglobulin (IgG/IgM) and C3, segmental subepithelial deposits and intracapillary fibrillar fibrin (Fig. 5).
IF - FIBRIN.
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F6
Immunofluorescence (IF) revealed global glomerular capillary wall positivity for IgG, trace IgM, 2+ C3, 1-2+ C1, 3+ kappa and trace lambda (Fig. 6, 7).
IF - IgG.
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F7
Immunofluorescence (IF) revealed global glomerular capillary wall positivity for IgG, trace IgM, 2+ C3, 1-2+ C1, 3+ kappa and trace lambda (Fig. 6, 7).