EM findings in two siblings who are both compound heterozygotes for the NPHS2 mutation and the R286fs pathogenic variant along with a non-neutral polymorphism R229Q. (A and B) The 63-year-old brother with serum creatinine 1.1 mg/dl, proteinuria 6.6 g/24 h, and serum albumin 3.4 g/dl. EM shows diffuse FPE. (C and D) The 47-year-old sister with serum creatinine 0.9 mg/dl, proteinuria 2.5 g/24 h, and serum albumin 4 g/dl. EM shows segmental FPE. Thick black arrow points to preserved foot processes, and thin black arrow points to effaced foot processes. Original magnification, ×5000 in A and B; ×2900 in C; ×4800 in D.