Membranous glomerulonephritis has been recognized as a pathological entity since it was described by Bell,1 and both he and others 2 have considered it closely related to acute glomerulonephritis. Ellis3 suggested that acute glomerulonephritis might appear initially in more than one form. His "Type I" nephritis included the usually recognized clinical picture of acute glomerulonephritis with hypertension, azotemia, hematuria, proteinuria, and edema, and his "Type II" nephritis fits the clinical and pathological picture of membranous glomerulonephritis with massive proteinuria and anasarca. This form of glomerulonephritis has frequently been described as a separate entity, lipoid nephrosis.4 However, lipoid nephrosis fits the pathological criteria for membranous glomerulonephritis1,3 and is both histologically and functionally predominantly a glomerulitis.5
Renal needle biopsy has allowed premortem microscopic examination of the kidney and has led to the recognition of membranous glomerulonephritis in the adult. Nine instances of the entity have been encountered