IgG4-Related Tubulointerstitial Nephritis Associated with Membranous Nephropathy in Two Patients: Remission after Administering a Combination of Steroid and Mizoribine
Figure 1
Representative microscopic histology. (a) Patchy infiltration of inflammatory cells and fibrosis in the interstitium with a clear border. Case 1. Masson trichrome stain, ×40. (b) Case 2. Masson trichrome stain, ×40. (c and d) Predominant infiltration of lymphocytes, plasma cells, and eosinophils into the interstitium. Case 1. H&E stain, ×400. (e) IgG4-positive plasma cells in the interstitium. Case 2. IgG4 immunoperoxidase stain, ×400. (f) Granular capillary wall staining for IgG. Case 1. Immunofluorescence, ×200. (g) IgG staining along the glomerular basement membrane (GBM). Case 1. IgG immunoperoxidase stain, ×400. (h) Weakly positive IgG4 staining along the GBM. Case 1. IgG4 immunoperoxidase stain, ×400. (i) Thickened GBM with spikes. Case 1. Periodic acid silver-methenamine stain, ×400. (j) Subepithelial electron-dense deposits. Case 1. ×20,000. (k) Subepithelial and mesangial electron-dense deposits. Case 2. ×10,000. (l) Scattered tubular basement membrane deposits. Case 2. ×4,000.
