PMC6346871_01
(A) Glomerulus with membranoproliferative features: increased lobulation, intracapillary hypercellularity and thickening of the capillary walls (haematoxylin-eosin x400); (B) arteriolar tortuosity with a narrow lumen (trichrome staining x400); (C) expansion of lamina rara interna and duplication of the glomerular basement membrane (electron micrograph x12,000)
542_Fig1.jpg
PMC6346871_01_542_Fig1.jpg
f1-542-1-3444-1-10-20170120
A kidney biopsy was performed (Fig. 1).
(A) Membranoproliferative features, glomerular capillary congestion, haemorrhage and acute tubular injury (haematoxylin-eosin x200); (B) afferent artery hyalinosis (haematoxylin-eosin x400); (C) severe intimal fibrosis and thrombus in the arterial lumen (trichrome staining x400)
542_Fig2.jpg
PMC6346871_01_542_Fig2.jpg
f2-542-1-3444-1-10-20170120
Because of the lack of recovery of kidney function after extubation, a new kidney biopsy was performed and revealed acute TMA with fibrin thrombi occluding the lumen of small arteries (Fig. 2).