PMC8216391_01
Lumbar spine magnetic resonance imaging. (A) A sagittal T1 sequence shows diffuse hypointense signal of the lumbo-sacral spine (red arrows). (B) An axial T2W sequence showing bilateral sacroiliitis (right > left; green arrow).
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Lumbar spine magnetic resonance imaging showed abnormal, diffuse, hypointense bone marrow signaling, and diffuse ankylosis of sacroiliac joints (right > left; Figure 1).
Histopathology and immunofluorescence of kidney biopsy. (A) Renal biopsy periodic acid-Schiff (PAS) stain, 100x magnification, showing multifocal endarteritis (black arrows) and mesangio-proliferative glomerulonephritis (Blue arrows). (B) Immunofluorescence showing arteriolar and glomerular IgM-kappa dominant deposits (Red arrows) consistent with cryoglobulinemic vasculitis and glomerulonephritis.
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Acute onset of renal failure which was otherwise unexplainable prompted kidney biopsy, which showed multifocal endarteritis with mild mesangial proliferative glomerulonephritis and IgM-kappa dominant deposits diagnostic of cryoglobulinemic vasculitis and glomerulonephritis (Figure 2).