PMC6159349_01
Clinical course. beta-hCG = human beta subunit of chorionic gonadotropin; Cre = creatinine; im = intramuscular injection; MTX = methotrexate; PSL = prednisolone; RB = renal biopsy; UP = urinary protein.
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Figure1
The clinical course after admission is shown in Figure 1. 
A, B: Light microscopy of initial renal biopsy specimens shows thickening of the glomerular capillary walls, thrombus-like structures within the glomerular capillary lumina, and a double-contour appearance along the glomerular capillary walls (A: Masson's trichrome stain x 400; B: Periodic acid-methenamine-silver stain x 400). C: Immunofluorescence microscopy shows positive staining for IgM along the glomerular capillary walls. D: Electron microscopy shows the expansion of the glomerular subendothelial space with electron-dense aggregates. E, F: Light microscopy of follow-up renal biopsy specimens shows normal glomerular structures (E: Masson's trichrome stain x 400; F: Periodic acid-methenamine-silver stain x 400).
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Figure2
Light microscopy showed thickened glomerular capillary walls with lumina occluded by thrombus-like structures and a double-contour appearance along the glomerular capillary walls (Figure 2A, B). Immunofluorescence microscopy showed 2+ staining for IgM, IgA, and fibrinogen, 1+ staining for C1q, and 0.5+ staining for IgG, kappa, lambda, and C3 along the glomerular capillary walls (Figure 2C). There were no alterations of the podocyte foot processes (Figure 2D). 