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Chest computed tomography images obtained on admission show a few nodules.
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Chest computed tomography (CT) revealed a few nodular shadows (Fig. 1).
Clinical course. mPSL: methylprednisolone
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On the third day of admission, his serum creatinine level had worsened to 8.51 mg/dL, and intermittent hemodialysis was initiated (Fig. 2).
A renal biopsy performed one month after his second dose of the COVID-19 vaccine shows necrotizing and crescentic glomerulonephritis. (a) PAS-stained section shows cellular crescents of the glomeruli. 400x. (b) Masson-stained section shows interstitial fibrosis and atrophy of the renal tubules. 100x. (c) EVG-stained section shows the proliferation of the vascular endothelial cells and rupture of an elastic fiber. 1,000x.
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Light microscopy revealed fibrinoid necrosis in the small vessels and proliferation of vascular endothelial cells, interstitial fibrosis, and atrophy of the renal tubules (Fig. 3).