PMC9930386_01
Serial chest radiographs (a-c) showing progressive bilateral diffuse alveolar opacities
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F1
Serial chest radiographs showed progressive bilateral diffuse alveolar opacities [Figure 1a-c].
Computed tomography of the chest revealed bilateral ground-glass opacities in central peribronchial regions, suggestive of diffuse alveolar hemorrhage
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F2
A high-resolution computed tomography of the chest revealed bilateral ground-glass opacities in central peribronchial regions, suggestive of DAH [Figure 2].
Renal biopsy showing glomerular mesangial hypercellularity on hematoxylin and eosin staining (a), fibrocellular crescents on Masson's trichrome staining (b, arrow), and intense (3+) IgA deposits in mesangium on immunofluorescence staining (c and d, arrows)
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F3
To establish the diagnosis, an ultrasound-guided percutaneous kidney biopsy was performed (on day 10 of hospitalization), which revealed mesangial hypercellularity and crescentic glomerulonephritis with fibrocellular and cellular crescents [Figure 3a and b]. Immunofluorescence studies showed intense (3+) staining of IgA deposits in mesangium and glomerular capillary loops [Figure 3c and d].