case_images: PMC6335885_01
case_images: (a) Low-power view of renal biopsy reveals advanced chronic injury (Masson's trichrome stain, x4). (b) One glomerulus displays ischemic changes in the form of thickening and wrinkling of glomerular capillary basement membranes and another (star) displays focal segmental glomerular sclerosis. Severe arteriolar hyaline (arrow) is evident (periodic acid-Schiff stain, x20). (c) Mild-to-moderate mesangial matrix expansion without significant hypercellularity (periodic acid-Schiff stain, x40). (d) Acute tubular injury and multifocal nuclear regenerative atypia (arrow) are identified, and polyomavirus, cytomegalovirus, and adenovirus immunostains were negative (H and E, x20). (e) Prominent peritubular capillary margination by inflammatory cells (red arrow, H and E, x40). (f) Peritubular capillary stain positive using C4d immunostain (black arrow, x40)
case_images: AJM-9-32-g001.jpg
case_images: PMC6335885_01_AJM-9-32-g001.jpg
case_images: F1
case_images: Creatinine level changes
case_images: AJM-9-32-g002.jpg
case_images: PMC6335885_01_AJM-9-32-g002.jpg
case_images: F2
case_images: The AMR responded partially with the gradual improvement of his Cr [Figure 2].