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. 2018 Jun 6;57(21):3129–3133. doi: 10.2169/internalmedicine.0806-18

Figure 2.

Figure 2.

Histological features of a kidney biopsy in a patient with TAFRO syndrome. (A) Lobulation of a glomerulus and mesangial proliferation can be seen in light microscopy sections (periodic acid-Schiff stain). (B) The glomerular capillary walls show focal double contouring (periodic acid-methenamine-silver stain). (C) Immunoperoxidase staining for CD68 (Nichirei Biosciences, Tokyo, Japan) shows many intraglomerular macrophages. (D) Double immunofluorescence staining for neutrophils (neutrophil elastase; Calbiochem, San Diego, USA) labeled with Alexa Fluor 488 (Thermo Fisher Scientific, Waltham, USA; green) and macrophages (CD68; Agilent, Santa Clara, USA) labeled with Alexa Fluor 594 (Thermo Fisher Scientific; red) shows massive macrophage infiltration within the tubulointerstitial area. The neutrophil infiltration is unremarkable. (E) Immunoperoxidase staining for CD34 (Agilent) shows prominently decreased CD34 immunoreactivity in some glomerular endothelial cells (arrows). Effacement of the podocyte foot processes (arrowheads) and mesangial interposition (Mes, F), expansion of the subendothelial space (asterisk, G), and infiltration of macrophages (MP, H) are shown in electron microscopy sections. There were no electron-dense deposits present (original magnification, A, B, C, 100×, D, 66×, E, 25×).