Fig. 2

Second Kidney Biopsy. a Hematoxylin and eosin (H&E) stain shows glomeruli with endocapillary hypercellularity including neutrophils and eosinophils. A few glomeruli showed cellular crescents (black arrow). b Spike lesions were noted on the silver stain (yellow arrow). c, d Granular and global staining of IgG and C3, predominantly on the capillary loops on immunofluorescence. e Electron microscopy shows numerous electron dense subepithelial deposits with diffuse overlying effacement of the podocyte foot processes. Several “hump” lesions were identified (red arrow)