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A 75 yr. old female patient presented with microscopic haematuria with RBC casts seen in the urine. Her serum creatinine was 3.9 mg/dl. Light microscopy and Silver staining of the Kidney specimen revealed the following: Which of the following would be the most appropriate diagnosis and the site of Ig deposits?

A
PSGN, subepithelial deposits
B
Type 1 MPGN, subendothelial deposits.
C
Membranous GN, subepithelial deposits
D
IgA nephropathy, mesangial deposits
High-Yield Explanation
The light microscopy reveals uniform thickening of basement membrane which when stained with Silver stain reveals the SPIKE and DOME pattern of staining seen in membranous GN. MPGN would reveal Tram track or splitting of GBM on electron and Silver stain. PSGN would reveal large hypercellular glomerulus with subepithelial deposits on electron microscopy.

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