case_images: PMC10796690_01
case_images: Renal pathological presentation of the patient. (A1): HE (hematoxylin-eosin) staining, x200 magnification. (A2): PAS (periodic Acid Schiff), staining, x400 magnification. (A3): PASM (periodic acid-silver methenamine) staining, x600 magnification. (A4): Masson staining, x400 magnification. Among the 4 glomeruli, glomerulosclerosis was observed in 1 glomerulus, while the other glomeruli showed glomerular mesangial cell and stroma mild hyperplasia. The capillary loops were open, with a stiff appearance. The basement membrane was thickened, with a small amount of spike-like structures visible. Subepithelial deposition of immune complexes was observed. No cellulose like necrosis, platinum ear-like structure or crescent formation was observed. The following changes were observed: granular and vacuolar degeneration of renal tubular epithelial cells, occasional protein tubular type, focal renal tubular lumen dilation accompanied by segmental epithelial cell detachment, brush border detachment, renal tubular atrophy, renal interstitial edema, small focal lymphoid and monocyte infiltration. There was no obvious lesion on the small artery wall.
case_images: fped-11-1230366-g001.jpg
case_images: PMC10796690_01_fped-11-1230366-g001.jpg
case_images: F1
case_images: Paraffin section fluorescence staining showed IgG1 subtype+, IgG4++, while negative in IgG2, IgG3, PLA2R, and THSD7A staining, consistent with stage II membranous nephropathy (Figures 1-3).
case_images: Glomerular findings by electron microscope. Under an electron microscope, the basement membrane showed mild irregular thickening, with a thickness of about 300-700 nm. The foot processes were diffusely fused, and a large amount of electronic dense material was deposited in the subepithelial and basement membranes. The epithelial cells of the renal tubules were vacuolated and degenerated, and there were no special changes in the renal interstitium.
case_images: fped-11-1230366-g002.jpg
case_images: PMC10796690_01_fped-11-1230366-g002.jpg
case_images: F2
case_images: Paraffin section fluorescence staining showed IgG1 subtype+, IgG4++, while negative in IgG2, IgG3, PLA2R, and THSD7A staining, consistent with stage II membranous nephropathy (Figures 1-3).
case_images: Glomerular findings by immunofluorescence staining. Epidemic immunofluorescence staining showed IgG deposits (++) in fine granular form along the capillary loop.
case_images: fped-11-1230366-g003.jpg
case_images: PMC10796690_01_fped-11-1230366-g003.jpg
case_images: F3
case_images: Paraffin section fluorescence staining showed IgG1 subtype+, IgG4++, while negative in IgG2, IgG3, PLA2R, and THSD7A staining, consistent with stage II membranous nephropathy (Figures 1-3).