case_images: PMC8185457_01
case_images: Kidney biopsy performed in 2013. Marked mesangial proliferation and diffuse simplification of the glomeruli. Hematoxylin eosin, x20.
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case_images: We performed a percutaneous kidney biopsy that revealed membranoproliferative glomerulonephritis (Figure 1) associated with a marked immunostaining positivity for C3 in a diffuse granular manner and mild mesangial segmental focal total IgG positivity.
case_images: Kidney biopsy performed in 2019. Glomerular enlargement with marked mesangial proliferation and diffuse lobular simplification of the glomeruli. Compared to the first biopsy, the glomeruli showed an accentuated lobular configuration and tubulointerstitial damage (tubular atrophy and fibrosis and inflammation). Hematoxylin eosin, x10.
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case_images: Hence, we readmitted our patient and in January 2019 performed a second kidney biopsy (Figure 2), which disclosed disease progression with presence of sclerosis (4/14 glomeruli) and a marked diffuse immunostaining positivity for C3, like the previous biopsy.
case_images: Kidney biopsy performed in 2019: electron micrograph showing an extensive circumferential electron-dense deposits (asterisks), and visceral epithelial foot process effacement (arrows). Scale bar 2.7 mum.
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case_images: Electron microscopy confirmed the diagnosis of membranoproliferative glomerulonephritis (Figure 3).