PMC8221701_01
Three manifestations of NSAID-associated renal disease: (1) membranous nephropathy, (2) superimposed minimal change disease, and (3) acute interstitial nephritis. (A) Glomerular capillary loops with subtle spikes/pinholes consistent with membranous nephropathy (arrows; 600x; Jones Silver Stain). (B) Interstitial inflammation and edema with conspicuous eosinophils (arrows; 400x; H&E stain). (C, D) Immunofluorescence staining demonstrating segmental weak granular capillary loop staining with (C) IgG and (D) C1q (400x). (E) Diffuse podocyte foot process effacement (arrows), condensation of the podocyte actin cytoskeleton, and microvillous transformation with a capillary loop without evidence of membranous-type deposits. (F) Capillary loops with variable subepithelial and intramembranous electron lucency suggestive of old resorbed membranous-type deposits (class IV membranous nephropathy) and diffuse podocyte foot process effacement.
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PMC8221701_01_10.1177_2050313X211025145-fig1.jpg
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There were no tubuloreticular inclusions or immune complex-type deposits present in any other location (see Figure 1).