Direct immunofluorescence showing granular mesangial staining for IgA in the expanded mesangium of the biopsy of patient 4, who had underlying diabetic glomerulosclerosis. Direct immunofluorescence showing granular mesangial staining for IgA in the expanded mesangium of the biopsy of patient 4, who had underlying diabetic glomerulosclerosis. The IgA fluorescence was not strong in most cases. Magnification ×400. Anjali A. Satoskar et al. CJASN 2006;1:1179-1186 ©2006 by American Society of Nephrology