Figure 216

Evolution of deposits in membranous glomerulonephritis. This schematic illustrates the sequence of immune deposits in red; basement membrane (BM) alterations in blue; and visceral epithelial cell changes in yellow. Small subepithelial deposits in membranous glomerulonephritis (predominately immunoglobulin G) initially form (A) then coalesce. BM expansion results first in spikes (B) and later in domes (C) that are associated with foot process effacement, as shown in gray. In later stages the deposits begin to resorb (dotted and crosshatched areas) and are accompanied by thickening of the capillary wall (D). (From Churg, et al. [6]; with permission.)

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