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Updated: Sep 7, 2025

Glomerular Outgrowth as an Ex Vivo Assay to Analyze Pathways Involved in Parietal Epithelial Cell Activation
06:39

Glomerular Outgrowth as an Ex Vivo Assay to Analyze Pathways Involved in Parietal Epithelial Cell Activation

Published on: August 19, 2020

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Subepithelial deposits with microspherular structures in membranous glomerulonephritis

Hae Yoon Grace Choung1, Jerome Jean-Gilles1, Bruce Goldman1

  • 1Department of Pathology and Laboratory Medicine, Division of Renal Pathology and Electron Microscopy, University of Rochester Medical Center, Rochester, NY, USA.

Ultrastructural Pathology
|June 16, 2022
PubMed

Insights

Membranous glomerulopathy (MGN) with subepithelial microspherular structures often indicates an underlying autoimmune disease, particularly lupus. Many cases lack primary MGN markers, suggesting secondary causes.

Area of Science:

  • Nephrology
  • Pathology
  • Immunology

Background:

  • Membranous glomerulopathy (MGN) can present with unique subepithelial microspherular structures.
  • These structures have been termed MGN with spherules or podocyte infolding glomerulopathy (PIG).
  • Previous studies suggest a link to autoimmune conditions, but further investigation is needed.

Purpose of the Study:

  • To investigate the clinical significance and underlying causes of MGN with subepithelial microspherular structures.
  • To determine the association with autoimmune diseases and common primary MGN markers.

Main Methods:

  • Retrospective analysis of 10 native kidney biopsies with identified subepithelial microspherular structures.
  • Review of patient demographics, clinical history, and autoimmune markers.
  • Immunohistochemical staining for PLA2R, NELL1, and THSD7A.

Main Results:

  • The majority of patients were Caucasian (80%) with a mean age of 51.3 years.
  • 50% of cases were associated with autoimmune disorders, predominantly Systemic Lupus Erythematosus (SLE) (80% of autoimmune cases).
  • 40% of cases were idiopathic and negative for PLA2R, NELL1, and THSD7A, suggesting secondary MGN.

Conclusions:

  • MGN with subepithelial microspherular structures is frequently associated with underlying autoimmune diseases.
  • The frequent absence of primary MGN markers supports a diagnosis of secondary MGN in these cases.
Keywords:
Membranous nephropathyautoimmune disordermembranous glomerulopathy with spherulesmicrospherulespodocyte infolding glomerulopathy (PIG)spherulessystemic lupus erythematosus

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