PMC7246398_01
Disease course after admission. The patient was suspected of SLE/AAV OS with serological features of SLE, and the treatment was changed to PSL monotherapy on day 8. Thereafter, the dosage of PSL was gradually decreased, and serum creatinine levels improved from a maximum of 7.06 mg/dL to 3.39 mg/dL on day 56.
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fig1
The disease course after admission is shown in Figure 1.
Global sclerosis was observed in two of a total 17 glomeruli. Cellular crescents and fibrinoid necrosis with rupture of Bowman capsule were observed in 14 of the remaining 15 glomeruli. (a) Masson's trichrome stain and (b) PAM stain showed cellular crescents and fibrinoid necrosis, with Bowman's capsule rupture.
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fig2
Cellular crescents and fibrinoid necrosis with rupture of Bowman capsule were observed in 14 of the remaining 15 glomeruli (Figure 2).
Immunofluorescence showed pauci-immune type crescentic glomerulonephritis (1+ deposition in a granular manner in the mesangial area of C3 only). Peroxidase antiperoxidase (PAP) method showed no deposition of IgG in the glomerular tuft free of crescent.
CRIN2020-5698708.003.jpg
PMC7246398_01_CRIN2020-5698708.003.jpg
fig3
Immunofluorescence showed pauci-immune type crescentic glomerulonephritis (1+ deposition in a granular manner in the mesangial area of C3 only) (Figure 3).