Figure 1
The evaluation of the patient's aortitis and renal disorder. MRA (a) and renal histologic (b-d, Periodic acid-Schiff stain) findings in the patient. MRA showed stenosis of the right brachiocephalic artery and proximal obstruction in the right subclavian artery (indicated by arrows). Renal histologic findings while proteinuria was worsening included mesangial proliferation with circumferential crescent formation (b, x200) and periglomerular mononuclear cell infiltration (c, x100). Small renal arteries showed medial thickening, endothelial cell proliferation, and thrombosis (d, x100, indicated by arrows). After treatment with PSL and an immunosuppressant, glomerular and tubular interstitial lesions decreased (e, x100). However, repeated relapses occurred, and a recent specimen showed sclerotic glomeruli (f, x200).