case_images: PMC10474789_01
case_images: Histopathological findings of renal biopsy. (a) Glomeruli showed no mesangial expansion and hypercellularity (PAS). Formation of a crescent or discontinuation and rupture of the capillary basement membrane are not observed (PAM). (b) Biopsy specimens reveal diffuse interstitial fibrosis and inflammation (Masson trichrome staining). (c) Foci of tubulitis (PAS). (d) Relatively large fibrotic foci are observed (HE and EVG). (e) Fibrosis of the arterial wall with focal destruction of the internal elastic lamina (EVG).. PAS: periodic acid-Schiff staining; MT: Masson trichrome staining; EVG: elastica van Gieson staining; HE: hematoxylin eosin staining.
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case_images: The remaining glomeruli showed minor abnormalities (Figure 1(a)). Diffuse interstitial inflammation and fibrosis were observed (Figure 1(b) and (c)). Large fibrotic foci were also observed, and some of the arterioles showed inflammation and fibrosis of the wall with focal destruction of the internal elastic lamina (Figure 1(d) and (e)).
case_images: High-resolution computed tomography of the chest. A chest CT scan on admission shows interstitial changes in bilateral lung bases accompanied by emphysema from the neck to the mediastinum and mild pneumothorax in both lungs.
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case_images: Clinical course of the patient.
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case_images: Serum creatinine improved to 0.99 mg/dL, urine protein-to-creatinine ratio turned negative 4 months after admission, and MPO-ANCA became undetectable after 1 year, with prednisolone 10 mg/day (Figure 3).