PMC8558788_01
Renal biopsy microscopic images. (a) Hematoxylin and eosin (H&E) stain at 40x magnification showing a glomerulus showing mild mesangial increase in cells. (b) Jones/Periodic Acid-Schiff (PAS) stain at 40x showing glomerulus with focal glomerular capillary wall thickening (rectangle) and vacuoles (arrow). (c) IgM immunofluorescence showing deposits in capillary walls.
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PMC8558788_01_10.1177_2050313X211056416-fig1.jpg
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To further investigate the hematuria and proteinuria, a kidney biopsy was done, which revealed mild mesangial hypercellularity and immune complex membranous glomerulonephritis with full house IgM/C3-dominant staining on immunofluorescence and reticular aggregates on electron microscopy, consistent with Membranous Lupus Nephritis Class V (Figure 1).