U # /121 Cad Tx 14/05/2004 Creatinine early December 2005. US normal.

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Presentation transcript:

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

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

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

C3

C3

Fibrin

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)