PMC3505547_01
Histologic and immunohistologic evaluations of the patient's kidney tissue. Mesangial proliferation is accompanied by crescent formation (a; PAS stain, x200), and immunoglobulin A deposits are demonstrated in the mesangium by immunofluorescence (b; x400). Mononuclear cell infiltration is seen in glomeruli (c; PAS, x400), which is supported by immunohistologic staining (d; x400). Fractalkine is demonstrated in the glomeruli (e; x400) and tubular epithelium (f; x200)
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Fig1
Kidney biopsy, performed when the daily urinary protein excretion discharge increased to 1.0 g/day, revealed the presence of cellular crescents in addition to a diffuse, marked increase in mesangium (Fig. 1a). An immunofluorescence study of the specimen demonstrated marked granular deposition of IgA (Fig. 1b) and complement C3 deposition, primarily in the mesangium. Mononuclear cell infiltration was also observed in glomeruli (Fig. 1c). Immunohistologic staining revealed glomerular infiltration of numerous CD68-positive macrophages (Fig. 1d). In a follow-up kidney specimen obtained 1 year and 6 months after the onset of nephropathy, mesangial proliferation was decreased (Fig. 1f).