What is your approach to differentiating secondary membranous nephropathy from infection-related glomerulonephritis in a patient with a bacterial infection who has borderline low complement studies?

This is primarily a biopsy distinction. Secondary membranous nephropathy is characterized by subepithelial immune complex deposits without cellular proliferation whereas infection-related glomerulonephritis Is characterized by endocapillary proliferation with large, subepithelial humps and often mes...

With MN, you get subepithelial deposits as the deposits are beneath the podocytes. There is no endocapillary hypercellularity in pure membranous, and the capillary lumina are patent. The thickening of the capillary wall is due to subepithelial deposits and new GBM formation. Depending upon the cause...