case_images: PMC10948170_01
case_images: Renal biopsy findings in patients with membranous glomerulonephritis (MGN). a, b Glomeruli exhibit focal segmental thickening of capillary loops, minimal tubular atrophy, and mild interstitial fibrosis. Mild interstitial inflammation is seen. There is no evidence of glomerular basement membrane spike formation (periodic acid-Schiff, original magnification 200). c Immunofluorescence staining for IgA, IgG, C1q, C3, Kappa, and Lambda reveals granular global glomerular capillary wall positivity, which is known as "full-house" deposition pattern and is typical seen in MGN. d Electron microscopy revealed minimal change with equivocal electron-dense deposits (arrowhead: microvilli transformation); early MGN was suspected.
case_images: crg-2024-0018-0001-537922_F01.jpg
case_images: PMC10948170_01_crg-2024-0018-0001-537922_F01.jpg
case_images: F1
case_images: Staining with hematoxylin and eosin, periodic acid-Schiff, and Jones methenamine silver showed focal segmental thickening of capillary loops, focal mild expansion of mesangial matrix, and mild tubular atrophy (shown in Fig. 1a, b). The tentative diagnosis was immune complex-mediated membranous nephritis with full-house immunofluorescence staining (shown in Fig. 1c). So minimal change with equivocal electron-dense deposits and early-stage membranous glomerulonephritis was suspected (shown in Fig. 1d).
case_images: Clinical course.
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case_images: PMC10948170_01_crg-2024-0018-0001-537922_F02.jpg
case_images: F2
case_images: And the subsequent titer of RPR showed remarkable decline, decreasing from 1:128 to 1:16 4 months after antibiotic treatment (Clinical course shown in Fig. 2.).