1. U # /121
Cad Tx 14/05/2004
Creatinine early December 2005.
US normal.
Original disease IgA nephropathy.

2. Original kidney disease: Buerger’s IgA
Cadaveric kidney transplant May post discharge baseline creatinine µmol/L
Serum creatinine 14/07/05: 104
Serum creatinine 29/11/05: Patient claims flu-like illness with dehydration
Repeat creatinine 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

10. 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)