18 August 2023
: Case report 
IgG4-Related Membranous Nephropathy with Acute Nephrotic Syndrome During Successful Steroid Maintenance Treatment for Type 1 Autoimmune Pancreatitis
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathology
Hiroshi Ito12ABCDEF, Kenji Ashida
12ABCDEF*, Mutsuyuki Demiya1BDE, Seiichi Motomura1BCDEF, Ayako Nagayama1BCDEF, Saori Kubo 3ABCDEF, Utako Ueda3ABCDEF, Kei Fukami3CDEF, Masatoshi Nomura1ACDE, Tomoyuki Akashi2BDE
DOI: 10.12659/AJCR.940707
Am J Case Rep 2023; 24:e940707
Figure 3. Pathological findings of the renal biopsy. The histopathological findings of the renal biopsy are shown. The tubulointerstitium and glomeruli appear normal on light microscopy. (A) Periodic acid-Schiff (PAS) staining. (B) Immunofluorescent staining for immunoglobulin G (IgG) reveals global granular glomerular basement membrane staining. (C) Immunostaining for anti-phospholipase A2 receptor (PLA2R) antibody reveals negative staining of the glomeruli. (D) Immunostaining results for the IgG4 subclass are shown. Staining for IgG2 and IgG3 was negative, whereas that for IgG1 and IgG4 was positive. Notably, strong staining was observed for IgG4.