PMC9047768_01
Trend of blood urea nitrogen and creatinine after presentation to outside
hospital (OSH).
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His laboratory data demonstrated his creatinine had now worsened to 5.77 mg/dL from 2.37 six days prior (Figure 1). Creatinine drastically rose from 5.77 mg/dL on admission to 11 mg/dL within only 4 days (Figure 1).
High-powered Periodic acid-Schiff (PAS) light microscopy demonstrated
glomeruli with features consistent with collapsing glomerulopathy. One such
glomerulus is depicted above.
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Kidney biopsy was performed shortly before dialysis was started, which was 4 days after presentation, and demonstrated collapsing focal segmental glomerulosclerosis consistent with a diagnosis of COVAN (Figures 2 -4).
High-powered PAS light microscopy demonstrated glomeruli with features
consistent with collapsing glomerulopathy. Another such glomerulus is
depicted above.
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Kidney biopsy was performed shortly before dialysis was started, which was 4 days after presentation, and demonstrated collapsing focal segmental glomerulosclerosis consistent with a diagnosis of COVAN (Figures 2 -4).
Electron microscopy demonstrated that podocytes are slightly enlarged with
moderate foot process effacement (70% of glomerular basement membrane
surface area). No electron dense deposits observed. Tubules show loss of
borders and protein reabsorption droplets.
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Kidney biopsy was performed shortly before dialysis was started, which was 4 days after presentation, and demonstrated collapsing focal segmental glomerulosclerosis consistent with a diagnosis of COVAN (Figures 2 -4).
Low-powered Hematoxylin-and-Eosin (H&E) light microscopy demonstrated
moderate interstitial fibrosis and tubular atrophy compromising
approximately 30% of the parenchyma.
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Moderate interstitial fibrosis and tubular atrophy were seen (Figure 5) with global collapse of capillary tufts (Figure 6).
High-powered H&E light microscopy demonstrated global collapse of
capillary tufts, mild nonspecific inflammation, protein reabsorption
droplets in tubules, acute tubular necrosis characterized by attenuation,
and flattening of the epithelial cells.
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Moderate interstitial fibrosis and tubular atrophy were seen (Figure 5) with global collapse of capillary tufts (Figure 6).