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case_images: Histopathological findings on the kidney biopsy.. Note. The kidney biopsy was performed with an 18-gauge needle. (a) Diffuse interstitial edema with multifocal and polymorphic cellular infiltrate, and tubulitis (periodic acid-Schiff stain). (b), Tubular injuries including tubulitis, breaks of tubular membrane, and necrosis of tubular cells (Silver Jones stain).
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case_images: Light microscopy showed a massive dense multifocal cellular infiltration of neutrophils, eosinophils, and lymphocytes with few plasma cells (Figure 1a). Tubular injuries including tubulitis, breaks of tubular basement membrane, and necrosis of tubular cells (Figure 1) were seen.
case_images: Features of thrombotic microangiopathy.. Note. The Silver Jones stain showed (a) ischemic glomerulus and (b) double contour of the glomerular basement membrane and mesangial edema.
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case_images: Glomeruli showed ischemic collapse (Figure 2a) or mesangiolysis and double contours of the glomerular basement membrane (Figure 2b).