Immunofluorescence microscopy in primary membranous nephropathy (PMN).

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Immunofluorescence microscopy in primary membranous nephropathy (PMN). Immunofluorescence microscopy in primary membranous nephropathy (PMN). (A) Finely granular staining for IgG, predominately IgG4, present uniformly in a subepithelial distribution in all glomeruli in a patient with PLA2R-associated PMN (original magnification, ×40) (generously provided by Dr. Charles Alpers, Department of Pathology, University of Washington, Seattle, WA). (B) Finely granular staining for PLA2R antigen that colocalizes with IgG4 in a patient with PMN. The presence of PLA2R indicates that anti-PLA2R antibody was present and forming deposits in glomeruli at the time of biopsy or within the past several weeks. (original magnification, ×40) (generously provided by Dr. Charles Alpers, Department of Pathology, University of Washington, Seattle, WA). (C) Finely granular staining for the complement membrane attack complex, C5b-9, in a patient with active PMN (original magnification, ×40). Reprinted from reference 89, with permission. William G. Couser CJASN 2017;12:983-997 ©2017 by American Society of Nephrology