Electron microscopy shows subepithelial electron-dense deposits with 'spike and dome' pattern on silver stain. Immunofluorescence shows granular IgG and C3 along the GBM. This is diagnostic of:

• A Membranoproliferative glomerulonephritis type I
• B Post-streptococcal glomerulonephritis
• C IgA nephropathy
• D Membranous nephropathy ✓

Explanation

Membranous nephropathy shows subepithelial deposits creating the classic 'spike and dome' pattern on Jones silver stain, with granular IgG (usually IgG4) and C3 along GBM. The majority of primary cases are due to anti-PLA2R antibodies targeting podocyte antigens. MPGN type I has subendothelial deposits and a tram-track pattern; post-streptococcal GN has subepithelial 'humps'; IgA nephropathy has mesangial deposits.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.