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Renal Biopsy Results: Acute Tubulointerstitial Rejection and Early Chronic Transplant Glomerulopathy

This case study describes the renal biopsy results of a patient who underwent a cadaveric kidney transplant and developed acute tubulointerstitial rejection. The biopsy also suggests early chronic transplant glomerulopathy. The patient experienced flu-like symptoms and dehydration, leading to increased creatinine levels and the need for further investigation.

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Renal Biopsy Results: Acute Tubulointerstitial Rejection and Early Chronic Transplant Glomerulopathy

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  1. U06-306#12581591/121 Cad Tx 14/05/2004 Creatinine 100 200 early December 2005. US normal. Original disease IgA nephropathy.

  2. Original kidney disease: Buerger’s IgA Cadaveric kidney transplant May 2004 - post discharge baseline creatinine 110-120 µmol/L Serum creatinine 14/07/05: 104 Serum creatinine 29/11/05: 168. Patient claims flu-like illness with dehydration Repeat creatinine 167. Follow-up creatinine missed. Biopsy planned post holidays MVA 04/01/06 Creatinine 262 blood and protein in urine Biopsy 06/01/06 Creatinine 209 13/01/06 Creatinine 178

  3. IF • IgG- Negative • IgA- Negative • IgM- Negative • C3- Moderate vascular and mild punctate mesangial staining • C1q- Negative • Kappa- Negative • Lambda- Negative • Fibrin- Moderate interstitial staining • Albumin- Negative • C4d- Negative

  4. C3

  5. C3

  6. Fibrin

  7. Diagnosis:Renal Biopsy (20 months post-transplantation):Acute tubulointerstitial rejection (Type IB) with signs of acute tubular injury and regeneration.Probable early chronic transplant glomerulopathy, suggested by Electron Microscopy.(G0 CG0 I2 CI2 T3 CT2 V0 CV2 AH0 MM1)

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