PMC9831936_01
PMC9831936_02
PMC9831936_03
Patient 2- Initial biopsy in 2012 with strong staining for IgG1 (a), weak staining for IgG2 (b), negative IgG3 (c), and strong staining for IgG4 (d) on immunofluorescence. Glomeruli are enlarged with an expanded mesangium on PAS stain (e). Electron microscopy shows classic fibrils (f). Subsequent biopsy in 2022 with strong staining for IgG1 (g), no significant staining for IgG2, IgG3, and IgG4 (h, i, and j, respectively). Glomeruli show further enlargement with increased mesangial expansion of PAS stain (k). Electron microscopy shows classic fibrils (l).
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PMC9831936_03_gr1.jpg
fig1
Immunofluorescence showed confluent staining for IgG with IgG1 dominance and trace staining for IgG4 and the other IgG subclasses (Figure 1 and Supplementary Figure S1).
PMC9831936_04
PMC9831936_05