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Pathology

Authoring team

The histopathology of membranous nephropathy exhibits the following features:

  • immune deposits:

  • localised on the subepithelial aspect of glomerular basement membrane and do not trigger any relevant inflammatory process

  • histological examination (e.g. periodic-acid silver methanamine staining, light microscopy of renal biopsy specimens) shows a diffuse thickening of glomerular capillaries with spike projections of glomerular basement membrane separated by immune deposits (non-stained material)

  • in advanced cases, a chain-like appearance is produced when projections of GBM completely surround the immune deposits

  • immunofluorescence microscopy:

  • shows diffuse granular deposition of IgG and C3 along the glomerular capillary wall

  • less frequently there is IgM, IgA, C1q and C4

  • immunofluorescence is important in the detection of early disease (initial deposits may be missed on light microscopy)

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