case_images: PMC9047768_01
case_images: Trend of blood urea nitrogen and creatinine after presentation to outside
  hospital (OSH).
case_images: 10.1177_23247096221093888-fig1.jpg
case_images: PMC9047768_01_10.1177_23247096221093888-fig1.jpg
case_images: fig1-23247096221093888
case_images: His laboratory data demonstrated his creatinine had now worsened to 5.77 mg/dL from 2.37 six days prior (Figure 1). Creatinine drastically rose from 5.77 mg/dL on admission to 11 mg/dL within only 4 days (Figure 1).
case_images: High-powered Periodic acid-Schiff (PAS) light microscopy demonstrated
  glomeruli with features consistent with collapsing glomerulopathy. One such
  glomerulus is depicted above.
case_images: 10.1177_23247096221093888-fig2.jpg
case_images: PMC9047768_01_10.1177_23247096221093888-fig2.jpg
case_images: fig2-23247096221093888
case_images: Kidney biopsy was performed shortly before dialysis was started, which was 4 days after presentation, and demonstrated collapsing focal segmental glomerulosclerosis consistent with a diagnosis of COVAN (Figures 2 -4).
case_images: High-powered PAS light microscopy demonstrated glomeruli with features
  consistent with collapsing glomerulopathy. Another such glomerulus is
  depicted above.
case_images: 10.1177_23247096221093888-fig3.jpg
case_images: PMC9047768_01_10.1177_23247096221093888-fig3.jpg
case_images: fig3-23247096221093888
case_images: Kidney biopsy was performed shortly before dialysis was started, which was 4 days after presentation, and demonstrated collapsing focal segmental glomerulosclerosis consistent with a diagnosis of COVAN (Figures 2 -4).
case_images: Electron microscopy demonstrated that podocytes are slightly enlarged with
  moderate foot process effacement (70% of glomerular basement membrane
  surface area). No electron dense deposits observed. Tubules show loss of
  borders and protein reabsorption droplets.
case_images: 10.1177_23247096221093888-fig4.jpg
case_images: PMC9047768_01_10.1177_23247096221093888-fig4.jpg
case_images: fig4-23247096221093888
case_images: Kidney biopsy was performed shortly before dialysis was started, which was 4 days after presentation, and demonstrated collapsing focal segmental glomerulosclerosis consistent with a diagnosis of COVAN (Figures 2 -4).
case_images: Low-powered Hematoxylin-and-Eosin (H&E) light microscopy demonstrated
  moderate interstitial fibrosis and tubular atrophy compromising
  approximately 30% of the parenchyma.
case_images: 10.1177_23247096221093888-fig5.jpg
case_images: PMC9047768_01_10.1177_23247096221093888-fig5.jpg
case_images: fig5-23247096221093888
case_images: Moderate interstitial fibrosis and tubular atrophy were seen (Figure 5) with global collapse of capillary tufts (Figure 6).
case_images: High-powered H&E light microscopy demonstrated global collapse of
  capillary tufts, mild nonspecific inflammation, protein reabsorption
  droplets in tubules, acute tubular necrosis characterized by attenuation,
  and flattening of the epithelial cells.
case_images: 10.1177_23247096221093888-fig6.jpg
case_images: PMC9047768_01_10.1177_23247096221093888-fig6.jpg
case_images: fig6-23247096221093888
case_images: Moderate interstitial fibrosis and tubular atrophy were seen (Figure 5) with global collapse of capillary tufts (Figure 6).