case_images: PMC11249791_01
case_images: Silver-stained section showing active cellular circumferential crescents with focal rupture of Bowman's capsule.
case_images: cnd-2024-0014-0001-538973_F01.jpg
case_images: PMC11249791_01_cnd-2024-0014-0001-538973_F01.jpg
case_images: F1
case_images: Forty-two glomeruli were present, 32 of which (76%) had cellular crescents, there was some evidence of fibrinoid necrosis, and 2 had associated rupture of Bowman's capsule (shown in Fig. 1).
case_images: IgA immunoperoxidase stain section showing linear IgA staining of the glomerular capillary walls (x200 magnification).
case_images: cnd-2024-0014-0001-538973_F02.jpg
case_images: PMC11249791_01_cnd-2024-0014-0001-538973_F02.jpg
case_images: F2
case_images: IgA staining of the glomerular capillary walls was demonstrated (shown in Fig. 2), suspicious of concurrent IgA anti-GBM disease; all other routine stains, including C3, were negative. In light of this and presence of alveolar haemorrhage, and despite the absence of a laboratory test to enable detection of possible circulating anti-GBM IgA, a decision was made to empirically treat for anti-GBM disease with 10 cycles of plasma exchange.