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U0 7 - 1891

U0 7 - 1891. #617894700 60 y.o. female with s/p renal transplant 1998 Increasing proteinuria. 60 yrs old female S/P DD renal Tx 29 March 1998 ESRD secondary to GN HTN Dyslipidemia Base line Cr 76 Medications: Cellcept, prednisone, Tacrolimus Avapro.

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U0 7 - 1891

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  1. U07-1891 #617894700 • 60 y.o. female with s/p renal transplant 1998 • Increasing proteinuria

  2. 60 yrs old female • S/P DD renal Tx 29 March 1998 • ESRD secondary to GN • HTN • Dyslipidemia • Base line Cr 76 • Medications: • Cellcept, prednisone, Tacrolimus • Avapro

  3. Presented with increasing proteinuria and hematuria • Pr /Cr 108 May 2006 • Pr/Cr 253 Nov 2006 • Work up: • Urine cytology normal • Cystoscopy normal • SPEP and UPEP normal

  4. IF • IgG-Negative. • IgA- Moderate mesangial staining. • IgM- Mild vascular staining. • C3- Mild punctate mesangial staining. Mild vascular staining. • C1q-Negative. • Kappa-Negative. • Lambda- Moderate mesangial staining. • Fibrinogen- Mild interstitial staining. Mild mesangial staining. • Albumin-Negative. • C4d- Negative.

  5. IgA

  6. IgM

  7. C3

  8. C3

  9. Lambda

  10. Fibrin

  11. Fibrin

  12. EM • pending

  13. DiagnosisRenal Biopsy: • Biopsy of marginal adequacy (only 4 glomeruli and no arteries) showing changes consistent with recurrent or de novo IgA nephropathy. • There is no definitive evidence of rejection • Banff scores: • G0 CG0 I0 CI1 T0 CT1 V- CV- AH2 MM0

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