Fig. 4

Kidney Biopsy. a Glomerulus with segmental sclerosis of the right half of the tuft, Periodic Acid-Methenamine Silver (PASM, 200×) b One glomerulus (left) with an ischemic appearance including capillary wall wrinkling and tuft retraction, other glomerulus (right) has mild hypercellularity including a few neutrophils (H&E, 100×) c A glomerulus with a bloodless appearance, obliteration of capillary lumens and thickening of capillary walls with segmental duplication (Periodic Acid-Schiff (PAS), 200×) d Tubules show cytoplasmic vacuolation, apical blebbing, thinning, and focal simplification. The interstitium contains a sparse lymphocytic infiltrate (PAS, 100×) e Electron micrograph of glomerular tuft showing ischemic-type capillary wall wrinkling (asterisk) and diffuse subendothelial electron lucent widening (arrow) f Electron micrograph showing podocyte foot process effacement (arrow) and mild subendothelial electron-lucent widening (asterisk)