case_images: PMC9936762_01
case_images: Skin findings as noted on the patient's right arm (a) and neck (b). Both sites exhibit multiple erythematous urticaria with evidence of previous excoriation.
case_images: gdz-0002-0189-g01.jpg
case_images: PMC9936762_01_gdz-0002-0189-g01.jpg
case_images: F1
case_images: Physical exam was notable for bilateral lower extremity edema, bilateral lung crackles, right cervical lymphadenopathy, and multiple erythematous urticaria on the midline neck and diffusely on the upper chest, back, and arms (Fig. 1). During her admission, the patient was found to have multiple erythematous urticaria on her upper arms and back (Fig. 1), which also lessened following dexamethasone therapy.
case_images: Kidney biopsy findings. a Light micrograph demonstrates a glomerulus involved by a membranoproliferative glomerulonephritis pattern of injury (Trichrome stain, x400). b Electron micrograph of a glomerular capillary loop demonstrating large subendothelial, mesangial, and few subepithelial immune complex deposits. Immunofluorescent micrographs of anti-human C1q antibody staining of (c) glomeruli and (d) tubulointerstitium demonstrating diffuse and global glomerular capillary wall and mesangial staining as well as extensive tubulointerstitial staining (x400).
case_images: gdz-0002-0189-g02.jpg
case_images: PMC9936762_01_gdz-0002-0189-g02.jpg
case_images: F2
case_images: The kidney biopsy (Fig. 2) was composed of cortex and corticomedullary junction containing 39 glomeruli (7 globally sclerotic).