case_images: PMC9930386_01
case_images: Serial chest radiographs (a-c) showing progressive bilateral diffuse alveolar opacities
case_images: TJEM-23-52-g001.jpg
case_images: PMC9930386_01_TJEM-23-52-g001.jpg
case_images: F1
case_images: Serial chest radiographs showed progressive bilateral diffuse alveolar opacities [Figure 1a-c].
case_images: Computed tomography of the chest revealed bilateral ground-glass opacities in central peribronchial regions, suggestive of diffuse alveolar hemorrhage
case_images: TJEM-23-52-g002.jpg
case_images: PMC9930386_01_TJEM-23-52-g002.jpg
case_images: F2
case_images: A high-resolution computed tomography of the chest revealed bilateral ground-glass opacities in central peribronchial regions, suggestive of DAH [Figure 2].
case_images: Renal biopsy showing glomerular mesangial hypercellularity on hematoxylin and eosin staining (a), fibrocellular crescents on Masson's trichrome staining (b, arrow), and intense (3+) IgA deposits in mesangium on immunofluorescence staining (c and d, arrows)
case_images: TJEM-23-52-g003.jpg
case_images: PMC9930386_01_TJEM-23-52-g003.jpg
case_images: F3
case_images: To establish the diagnosis, an ultrasound-guided percutaneous kidney biopsy was performed (on day 10 of hospitalization), which revealed mesangial hypercellularity and crescentic glomerulonephritis with fibrocellular and cellular crescents [Figure 3a and b]. Immunofluorescence studies showed intense (3+) staining of IgA deposits in mesangium and glomerular capillary loops [Figure 3c and d].