PMC9192312_01
(a) Endoscopic image showing the evidence of hemorrhagic gastritis. (b) Colonoscopic view showing the presence of bowel wall edema.
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fig1
Light microscopic images (H&E staining). Normal duodenal lining: (a) (4X). (b) (10X). Normal ileal lining: (c) (4X). (d) (10X). Normal rectal lining: (e) (4X). (f) (10X). Normal lining of sigmoid colon: (g) (4X). (h) (10X).
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fig2
Figures 2 and 3 show light microscopic appearance of different GI segments at different power fields.
Light microscopic images (H&E staining). (a) Normal duodenal lining (40X). (b) Normal colonic lining (40X).
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fig3
Figures 2 and 3 show light microscopic appearance of different GI segments at different power fields.
Markedly thickened edematous bowel loops at different segments of GI tract with extensive mucosal enlargement. Patent abdominopelvic vessels with no evidence of ischemia. (a) Axial view, (b)-(c) coronal view, and (d) sagittal view.
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fig4
Contrast enhanced CT scan abdomen (CECT) was repeated, which showed worsening of the disease process with panenteritis involving large and small bowel up to the esophagus.  Figure 4 shows CECT abdomen images.
H&E stain at (a) 10X and (b) 40X. (c) PAS stain at 40X. Blue arrow represents the marked endocapillary hypercellularity and proliferation. Maroon arrow represents the tubulointerstitial inflammation.
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fig5
As her serum creatinine was 3 mg/dL with ongoing proteinuria, therefore, her renal biopsy was performed.  Figure 5 shows histopathological images obtained after renal biopsy.
Summary of treatment received by the patient.
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fig6
The flowchart in Figure 6 shows the treatment received by the patient.