PMC7552349_01
Renal histology showing segmental minimal mesangial hypercellularity (Periodic acid-Schiff stain, 400x), mesangial IgA deposition (immunofluorescence-IgA, 400x), and paramesangial electron-dense deposits (electron microscopy, 15,000x).
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Figure1
Electron microscopy confirmed the dense paramesangial deposits with intact podocyte foot processes (Figure 1).
Marked reduction in urine copper and stabilization of serum ceruloplasmin with copper chelation.
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Figure2
During a 30-month follow-up period, his palpable purpura resolved and liver enzymes normalized between 3 and 6 months after initiation of trientine and zinc. 24-hour urine copper remained markedly suppressed (Figure 2).