JMA Journal

Figure 1. Physical examination showed papuloerythmatous plaques on the backs of the patient’s bilateral fingers.

Figure 2. Light microscopy of the kidney showing diffuse mesangial hypercellularity (A, periodic acid-Schiff staining, 400×); spike formation (black arrows) and double contouring (white arrowheads) of the glomerular basement membrane (B, periodic acid-methenamine-silver staining, 800×); no arterial lesions (C, Masson’s trichrome staining, 400×); mild tubular atrophy (D, periodic acid-Schiff staining, 400×).

Figure 3. Immunofluorescence microscopy of the kidney showing the depositions of immunoglobulins G, A, and M, and C1q. (A) immunoglobulin G; (B) immunoglobulin A; (C) immunoglobulin M; (D) C1q, 400×.