Figure 1. Photomicrographs from the first biopsy showing enlarged hypercellular glomeruli with lobular accentuation, mesangial cell proliferation, and thickened basement membrane (a, H&E ×200). Silvermethenamine stain showing mesangial cell interposition with "splits" of basement membrane (b, ×400). Immunofluorescence showing capillary wall granular staining for C3 (c, ×200). Electron micrograph demonstrating large sub-endothelial electron-dense deposits (d, ×2200).