02 April 2025
: Case report 
Successful Treatment of a 42-Year-Old Man with Concurrent Anti-Glomerular Basement Membrane Disease and Anti-Phospholipase A2 Receptor Antibody-Positive Membranous Nephropathy: A Case Report
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Rare disease
Cuirong Hu BCEF 1, Jinkun Wang E 1, Yaping Zhan E 1,2, Jifang Lu E 1, Jinling Ye E 1, Jianan Chen E 1, Wenyan Zhou C 2, Chaojun Qi E 2, Minfang Zhang D 2, Leyi Gu E 1,2, Na Jiang AEF 1,2*DOI: 10.12659/AJCR.946245
Am J Case Rep 2025; 26:e946245
Figure 2. Representative photos of kidney biopsy. Panel A shows small fibrocellular crescents in the glomeruli (arrow). Proximal tubules show evidence of loss of the brush border, with dilation of the tubules and vascular wall intimal fibrosis (PAS, magnification: 100×). Panel B shows a representative glomerulus with a large cellular-fibro crescent and segmental necrosis (arrow, PASM, magnification: 400×). Panel C depicts electron-dense immune complex-type deposits in the subepithelial layer and inside the glomerular basement membrane (GBM, arrow), which is diagnostic for membranous glomerulopathy. Panel D demonstrates immunofluorescence IgG staining showing 3+ positivity linear and granular along the capillary loop (magnification: 1000×), indicating anti-GBM disease combined with membranous glomerulopathy. Panel E shows immunofluorescence staining demonstrating positivity of 3+ intensity for anti-PLA2R antibody expression (magnification: 400×). PAS – periodic acid Schiff staining; PASM – periodic acid silver methenamine staining; GBM – glomerular basement membrane; IgG – immunoglobin G; PLA2R – phospholipase A2 receptor.