PMC7204776_01
a Light microscopy showing minor glomerular abnormalities and very mild segmental mesangial proliferation (arrowheads). Moderate hyalinosis of the artery is also seen (arrow). Periodic acid Schiff staining with original magnification x400. b Faint and segmental positive immunostaining of IgA, IgG, and C3 in the mesangial area. c Electron microscopic examination revealing diffuse effacement of podocyte foot processes. Electron-dense deposits are seen in the paramesangial areas (arrowheads). Electron microscopy, original magnification x2,500.
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F1
The glomeruli showed minor abnormalities, including very mild segmental mesangial expansion (Fig. 1a). Immunofluorescence analysis revealed faint and segmental mesangial deposits of IgA, IgG, and C3 (Fig. 1b). Electron-dense deposits were seen in the paramesangial areas, and they were less frequent and of lower density than those observed in typical IgA nephropathy (Fig. 1c).
Anasarca and cardiomegaly were aggravated for several days. Aggressive fluid removal by hemodialysis was effective for improving renal function. After the discontinuation of hemodialysis, prednisolone treatment was started, and complete remission of NS was achieved. BW, body weight; Cr, creatinine; HD, hemodialysis; mPSL, methylprednisolone; PSL, prednisolone; Up, urinary protein; UV, urinary volume.
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F2
Her prednisolone dosage was tapered gradually over several months, and she has remained in complete remission without relapse (Fig. 2).