PMC9382069_01
Occlusive right posterior tibial vein with no venous blood
flow.
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Lower extremity venous dopplers showed an occlusive thrombus in the right posterior tibial vein (Figure 1).
Computed tomography angiography of the chest: bilateral pulmonary
emboli.
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CT pulmonary angiography (CTPA) of the chest showing filling defects in the distal main bilateral pulmonary arteries extending into segmental branches in both upper and lower lobes consistent with bilateral pulmonary emboli (Figure 2).
Electron microscopy of left kidney biopsy showing minimal change
disease: effacement of foot processes, normal glomerular
basement membranes, and no immune complexes.
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Electron microscopy showed effacement of foot processes of the visceral epithelial cells with effacement in 70% of the foot processes (Figure 3).
Light microscopy of left kidney biopsy: (a) normal glomerulus, (b)
normal interstitium with mild vascular sclerosis, and (c) mild
intimal fibrous thickening.
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The glomeruli were normocellular (Figure 4(a)) with thin peripheral capillary walls and open capillary spaces. There was mild thickening of the walls of arterioles/small size arteries and mild intimal fibrous in larger arteries (Figure 4(b)). There was minimal, focal interstitial fibrosis without evidence of tublitis or vasculitis (Figure 4(c)).