PMC9978203_01
Representative images of renal pathology in case 1. Light microscopy: Most glomerular segmental mesangial cells were mildly hyperplasia, and the mesangial stroma was hyperplasia. There was no obvious lesion in the glomerular basement membrane, and no dense deposits were seen under the endothelial and epithelium. Renal tubular epithelial cells showed degeneration. Atrophy was seen in some segments of renal tubules, and the basement membrane of renal tubules was thickened in some segments. The renal interstitium was widened, and flaky fibrosis was seen. (A, PAS, magnification x 400; B, PASM, magnification x 400; C, Masson, magnification x 400). Immunofluorescence microscopy: IgM (+++) was deposited in the glomerular mesangial region and capillary wall as a mass of immunofluorescence. (D, magnification x 200). Transmission electron microscopy: Most segments of the capillary basement membrane had no obvious lesions, and a few segments showed mesangial insertion. The rough endoplasmic reticulum in podocytes expanded, mitochondria swelled, small lipid droplets and lysosomes increased slightly, and foot processes fused widely. The mesangial matrix was mild to moderate hyperplasia, and a small amount of the dense deposits was seen in the mesangial area (E,F).
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F1
IgM nephropathy with glomerulosclerosis and interstitial tubular lesions was diagnosed by renal biopsy (Figure 1).
Blood albumin, UACR and eGFR at the follow-up of case 1. After 60.0 months of follow-up, the eGFR of case 1 was 14.8 ml/(min x 1.73 m2). UACR, urinary albumin to creatinine ratio; eGFR, estimated glomerular filtration rate.
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F2
However, they still had nephrotic range proteinuria most of the time, and the proteinuria had not disappeared (Figures 2, 3). Figures 2, 3, respectively, display the renal function of the two cases during the follow-up.
Blood albumin, UACR and eGFR at the follow-up of case 2. After 53.0 months of follow-up, the eGFR of case 2 was 12.2 ml/(min x 1.73 m2). UACR, urinary albumin to creatinine ratio; eGFR, estimated glomerular filtration rate.
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F3
However, they still had nephrotic range proteinuria most of the time, and the proteinuria had not disappeared (Figures 2, 3). Figures 2, 3, respectively, display the renal function of the two cases during the follow-up.