Deposition of Complement Product C4d in Anti–Glomerular Basement Membrane Glomerulonephritis  Ibrahim Batal, MD, Geetha Chalasani, MD, Christine Wu, MD, Ron Shapiro, MD, Sheldon Bastacky, MD, Parmjeet Randhawa, MD  American Journal of Kidney Diseases  Volume 53, Issue 6, Pages 1098-1101 (June 2009) DOI: 10.1053/j.ajkd.2008.10.008 Copyright © 2009 National Kidney Foundation, Inc. Terms and Conditions

Figure 1 (A) Glomerulus with cellular crescent identified in the initial allograft biopsy specimen (hematoxylin and eosin; original magnification ×400). (B) Three glomeruli with diffuse linear staining for immunoglobulin G antibodies (immunofluorescence; original magnification ×200). American Journal of Kidney Diseases 2009 53, 1098-1101DOI: (10.1053/j.ajkd.2008.10.008) Copyright © 2009 National Kidney Foundation, Inc. Terms and Conditions

Figure 2 (A) Frozen tissue shows diffuse C4d deposits in peritubular capillaries (PTCs; arrows). The extent and pattern of staining are similar to those described in the setting of antibody-mediated rejection (monoclonal C4d immunostain [Biogenesis]; original magnification ×400). (B) Formalin-fixed paraffin-embedded tissue shows diffuse PTC C4d deposits similar to those seen on the frozen section. PTC staining in our hands tends to have a granular quality in both allograft and nonallograft kidney specimens (polyclonal C4d immunostain [ALPCO Diagnostics]; original magnification ×400). American Journal of Kidney Diseases 2009 53, 1098-1101DOI: (10.1053/j.ajkd.2008.10.008) Copyright © 2009 National Kidney Foundation, Inc. Terms and Conditions

Figure 3 (A) Glomerulus with cellular crescent and adjacent tubulointerstitial inflammation in the native biopsy specimen. (B) Higher magnification of foci of tubulitis (arrows) (periodic acid–Schiff stain; original magnification [A] ×400, [B] ×600). American Journal of Kidney Diseases 2009 53, 1098-1101DOI: (10.1053/j.ajkd.2008.10.008) Copyright © 2009 National Kidney Foundation, Inc. Terms and Conditions