PMC7994079_01
27 glomeruli were seen on the renal biopsy specimen with the following histological findings. (a) Fibrocellular crescents in the glomeruli and lymphocyte infiltration around the tubule-interstitium near the glomerulus (periodic acid-Schiff (PAS) staining x200). (b) Glomerulus with large crescent and collapsed tuft (Jones Silver staining x200). (c, d) Immunofluorescence staining revealed linear staining along the glomerular capillary loops (IgG staining x400).
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fig1
Renal biopsy revealed findings consistent with rapidly progressing glomerulonephritis with 100% cellular crescents and immunofluorescence exhibiting diffuse linear staining along the glomerular basement membrane with IgG (3+), C3 (3+), kappa (3+), and lambda (2+) stains (Figures 1(a)-1(d)).
Computed tomography pulmonary angiogram showing no pulmonary embolism; multifocal pulmonary infiltrates; small right-sided pleural effusion; very small pericardial effusion; cardiomegaly.
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fig2
Given concerns for shortness of breath and chest tightness, a chest X-ray and chest computed tomography (CT) scan (Figure 2) were performed and were negative for pulmonary embolism though she developed bilateral patchy infiltrates of undetermined etiology while being on chronic immunosuppression for the last two months with tacrolimus, azathioprine, and prednisone.