PMC7350396_01
Initial kidney biopsy showing tubular epithelial cell injury characterized by cellular swelling (a) and collapsing segmental sclerosis of the glomerulus, due to the accumulation of detached, injured podocytes with in Bowman's capsule (b).
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The patient underwent a kidney biopsy and the results showed an acute tubular epithelial cell injury with focal sclerotic glomeruli and mild mesangial hypercellularity (Figure 1).
Electron microscopy showing podocyte effacement from the glomerular basement membrane (a). Positive immunofluorescence for deposition of kappa light chain (b) and lambda light chain (c) in the glomerular capillary loops on the repeat kidney biopsy.
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Immunofluorescence on frozen tissue was negative for staining and electron microscopy was negative for immune deposits but showed 40% podocyte effacement (Figure 2).