case_images: PMC4011777_01
case_images: The evaluation of the patient's aortitis and renal disorder. MRA (a) and renal histologic (b-d, Periodic acid-Schiff stain) findings in the patient. MRA showed stenosis of the right brachiocephalic artery and proximal obstruction in the right subclavian artery (indicated by arrows). Renal histologic findings while proteinuria was worsening included mesangial proliferation with circumferential crescent formation (b, x200) and periglomerular mononuclear cell infiltration (c, x100). Small renal arteries showed medial thickening, endothelial cell proliferation, and thrombosis (d, x100, indicated by arrows). After treatment with PSL and an immunosuppressant, glomerular and tubular interstitial lesions decreased (e, x100). However, repeated relapses occurred, and a recent specimen showed sclerotic glomeruli (f, x200).
case_images: 1546-0096-12-15-1.jpg
case_images: PMC4011777_01_1546-0096-12-15-1.jpg
case_images: F1
case_images: This was confirmed when magnetic resonance angiography (MRA) demonstrated stenosis of the right subclavian artery (Figure  1a). Some circumferential crescent formation was seen (Figure  1b). Marked mononuclear cell infiltration was present in the interstitium, mainly near glomeruli (Figure  1c). The specimen showed decreases of mesangial proliferation, crescents, and periglomerular mononuclear cell infiltration (Figure  1d).