case_images: PMC11042795_01
case_images: a Periodic acid-Schiff (PAS) stain shows only slight thickening of the GBM. Jones silver stain did not reveal any discernible spikes or craters in this case. This feature combined with the immunohistochemical study result is typical for early membranous nephropathy (case 1). b IgG immunohistochemical stain shows intense granular staining of the capillary walls case 1. c C4d immunohistochemical stain shows intense granular staining of the capillary walls. C4d is a helpful adjunct "surrogate" marker for early membranous nephropathy (case 1). d Electron microscopy reveals glomerular basement membrane with multiple, mainly discrete, subepithelial electron dense deposits (arrows). Paraffin extracted tissue, magnification, x8,000.
case_images: gdz-2024-0004-0001-538492_F01.jpg
case_images: PMC11042795_01_gdz-2024-0004-0001-538492_F01.jpg
case_images: F1
case_images: The histopathologic evaluation of the biopsy specimens, including three renal tissue cores containing up to 34 glomeruli, did not reveal global sclerosis under light microscopy (Fig. 1).
case_images: Response to treatment for both cases. Evolution of serum albumin and 24-h urine protein. RTX, rituximab course 1 g 2 weeks apart.
case_images: gdz-2024-0004-0001-538492_F02.jpg
case_images: PMC11042795_02_gdz-2024-0004-0001-538492_F02.jpg
case_images: F2
case_images: Upon the discussion with the neurologist, he received a second course of rituximab at 1 g, which was administered in 2 doses 2 weeks apart in April 2023 (Fig. 2).
case_images: PMC11042795_02
case_images: Response to treatment for both cases. Evolution of serum albumin and 24-h urine protein. RTX, rituximab course 1 g 2 weeks apart.
case_images: gdz-2024-0004-0001-538492_F02.jpg
case_images: PMC11042795_02_gdz-2024-0004-0001-538492_F02.jpg
case_images: F2
case_images: Upon the discussion with the neurologist, he received a second course of rituximab at 1 g, which was administered in 2 doses 2 weeks apart in April 2023 (Fig. 2).
case_images: a H&E stain image shows segmental scar with adhesion to Bowman capsule (case 2). b Trichrome stain shows segmental scar with adhesion to Bowman capsule (case 2).
case_images: gdz-2024-0004-0001-538492_F03.jpg
case_images: PMC11042795_02_gdz-2024-0004-0001-538492_F03.jpg
case_images: F3
case_images: He was initially treated with intravenous diuretics and intravenous human albumin and underwent renal biopsy (Fig. 3).