PMC9035826_01
PMC9035826_02
Timelines of clinical events, diagnostic exams, and treatments of patients. Above:the timeline of patient 1 and below: the timeline of patient two.
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PMC9035826_03_fimmu-13-854749-g001.jpg
f1
The timeline of the events and treatments is presented in  Figure 1 .
The result of the renal biopsy shows (A) diffuse global glomerulosclerosis. Periodic acid Schiff (PAS) stain original magnification: x100. (B) Glomerular basal membrane (GBM) thickening. PAS stain original magnification: x400. (C) Prominent vacuolated appearance of GBM indicated by the arrow. Jones methenamine silver, original magnification: x1,000. (D) No PLA2R immune deposits (immunofluorescence, original magnification: x400).
fimmu-13-854749-g002.jpg
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Light microscopy findings included a membranous pattern with 63% (7 out of 11) obsolete glomerulus ( Figures 2A-C ). The M-type phospholipase A2 receptor (PLA2R) antibody was absent in serum, and the PLA2R antigen was absent in tissue as well as thrombospondin type 1 domain-containing 7A (THSD7A) antigen in tissue ( Figure 2D ).
PMC9035826_03
Timelines of clinical events, diagnostic exams, and treatments of patients. Above:the timeline of patient 1 and below: the timeline of patient two.
fimmu-13-854749-g001.jpg
PMC9035826_03_fimmu-13-854749-g001.jpg
f1
The timeline of the events and treatments is presented in  Figure 1 .
(A) Mild thickening of the capillary wall and glomerular basement membrane. Bowman capsule enlargement and reduplication (periodic Schiff-methenamine silver, original magnification: x400). (B) Interstitial and peri-tubular IgG4 deposits. Mild tubular atrophy and interstitial fibrosis. Moderate focal and periglomerular lymphoplasmacytic infiltrate (PAS + IgG4 IHC, original magnification: x100). (C) Glomerular sub-epithelial deposits with granular pattern (immunofluorescence for anti-PLA2R antibodies, original magnification: x400). (D) Absence for THSD7A glomerular expression (IHC original magnification: x200).
fimmu-13-854749-g003.jpg
PMC9035826_04_fimmu-13-854749-g003.jpg
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PMC9035826_04
(A) Mild thickening of the capillary wall and glomerular basement membrane. Bowman capsule enlargement and reduplication (periodic Schiff-methenamine silver, original magnification: x400). (B) Interstitial and peri-tubular IgG4 deposits. Mild tubular atrophy and interstitial fibrosis. Moderate focal and periglomerular lymphoplasmacytic infiltrate (PAS + IgG4 IHC, original magnification: x100). (C) Glomerular sub-epithelial deposits with granular pattern (immunofluorescence for anti-PLA2R antibodies, original magnification: x400). (D) Absence for THSD7A glomerular expression (IHC original magnification: x200).
fimmu-13-854749-g003.jpg
PMC9035826_04_fimmu-13-854749-g003.jpg
f3