case_images: PMC9905412_01
case_images: The bone marrow cytology and pathological biopsy. The bone marrow cytology (A) revealed active proliferation of hematopoietic cells including granulocyte, erythroid, and megakaryocyte lineages (black arrows point to promyelocytes, green arrows point to mature granulocytes, yellow arrows point to the immature red blood cells in the middle and late stages, and red arrows point to mature lymphocytes). (B) The biopsy of the bone marrow showed that myeloproliferation is normal and hematopoietic tissue is 50% (black arrows indicate adipose tissue and red arrows indicate hematopoietic tissue).
case_images: fmed-10-1014261-g0001.jpg
case_images: PMC9905412_01_fmed-10-1014261-g0001.jpg
case_images: F1
case_images: The bone marrow cytology revealed active proliferation of hematopoietic cells, including granulocyte, erythroid, and megakaryocyte lineages (Figure 1A), and the pathological biopsy of the bone marrow showed that myeloproliferation is normal (Figure 1B).
case_images: Renal pathology in mixed cryoglobulinemia. Light microscopy ( x 10). (A) PAS stain shows membranoproliferative glomerulonephritis characterized by nodular lobulated changes in glomeruli, segmentally thickened and double-contoured appearance of the glomerular basement membrane (black arrow), diffuse intracapillary cell accumulation, and inflammatory cell infiltration (red arrow). (B) Immunofluorescence studies showing Immunoglobulin G deposit in vascular loops with line-like (white arrow).
case_images: fmed-10-1014261-g0002.jpg
case_images: PMC9905412_01_fmed-10-1014261-g0002.jpg
case_images: F2
case_images: A renal biopsy was performed, and it showed membranoproliferative glomerulonephritis and was considered pathological changes of cryoglobulinemic glomerulonephritis (Figure 2).
case_images: The results of capillary electrophoresis directing analysis of serum by capillary electrophoresis with detection at 200 nm. Polyclonal IgG kappa and IgA kappa proteins are identified in the serum of the patient by using fully automated capillary electrophoresis. The ELP pattern of (A) (yellow line) is the original serum line which is the electrophoresis result of the original sample. (B) The serum contains an IgG polyclonal protein. (C) The serum contains an IgA polyclonal protein. (D) The serum does not contain an IgM protein. (E) The serum contains a kappa chain, and (F) the serum does not contain a light chain.
case_images: fmed-10-1014261-g0003.jpg
case_images: PMC9905412_01_fmed-10-1014261-g0003.jpg
case_images: F3
case_images: The electropherograms can be obtained (Figure 3).