case_images: PMC11739319_01
case_images: Abdominal ultrasonography and abdominal/chest CT scans of the patient. (A) Abdominal color ultrasonography indicates excessive ascites; (B) diffuse parenchymal thickening of the liver; (C) splenic veins are tortuous and dilated; (D) the black arrows show intrahepatic lymphatic dilatation; the blue arrow shows splenomegaly; and the red arrow shows collateral circulation; (E-H) show changes in chest CT infection lesions over time.
case_images: fimmu-15-1475303-g001.jpg
case_images: PMC11739319_01_fimmu-15-1475303-g001.jpg
case_images: f1
case_images: ADAMTS13 inhibitor was negative, LDH and creatinine levels increased, and troponin I level increased to 0.087 ng/mL. Abdominal color ultrasonography revealed a large amount of ascites, diffuse liver lesions, splenomegaly, and varicose splenic dilation ( Figure 1 ). Enhanced CT revealed diffuse liver disease along the portal veins, intrahepatic lymphatic dilatation, esophageal and gastric varices, a splenorenal vein shunt, and splenomegaly ( Figure 1 ). Lung infection lesions increased ( Figure 1 ).
case_images: Graph illustrating the evolution of key laboratory parameters and the treatments administered. Panels (A-D) represent the changes in the most relevant laboratory parameters over time; panel (E) depicts the different treatments administered to the patient. Hb, hemoglobin; Plt, platelet count; RDW-CV, red cell distribution width coefficient of variation; Ret, reticulocyte ratio; Cr, creatinine; ESR, erythrocyte sedimentation rate; 24-h UP, 24-h urinary protein; MP, methylprednisolone; IVIg, gamma globulin; TAc, tacrolimus; MMF, mycophenolate; PE, plasma exchange; LMWH, low-molecular-weight heparin.
case_images: fimmu-15-1475303-g002.jpg
case_images: PMC11739319_01_fimmu-15-1475303-g002.jpg
case_images: f2
case_images: On the 59th day, the patient's symptoms and laboratory indices improved ( Figure 2 ).