PMC4676347_01
Bronchoscopy with bronchoalveolar lavage of the patient. (A) Bronchoscopy demonstrated intact lung mucosa. (B) Bronchoscopy demonstrated hemorrhagic bronchoalveolar lavage.
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F1
Bronchoalveolar lavage showed alveolar hemorrhage with clean lung mucosa (Fig. 1).
Kidney biopsy of the patient. (A) The light microscopy demonstrated diffuse necrotizing and crescentic glomerulonephritis. (B) The immunofluorescence showed linear staining due to IgG deposition.
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F2
The punctate granular electron densities permeating some compressed glomerular basement membranes and the matrix of the crescent correlate with the immunofluorescence positivity for IgG, kappa and lambda (Fig. 2).
Comparison of imaging before and after treatment (plasmaphoresis). (A) HRCT showing alveolar and interstitial pulmonary edema of bilateral lung fields. (B) CT of thorax showing interval resolution of the alveolar and interstitial pulmonary edema after plasmaphoresis.
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F3
Repeat chest X-ray and CT of thorax showed significant improvement after the treatment (Fig. 3).