CASE 152 (October 2018)

Clinical information

The patient is a 37-year-old woman with type 1 diabetes mellitus from 17 years of age. She was kidney and pancreas transplanted 9 months before, from cadaveric donor.

She was evaluated for increased serum creatinine: from 1.1 mg / dL to 2.1 mg/dL, BUN: 28 mg/dL. She also reports dysuria and hematuria. Uroanalisis: reddish color, proteins 500 mg/dL, sediment with leukocytes: 12-15/HPF, erythrocytes 60/HPF, 90% crenated, bacteria are not observed. Proteinuria 24 hours: 2.1 g. Tacrolimus levels: 5.9 ng/mL. Pancreatic graft with adequate function. Kidney graft ultrasound without perirenal collections; Doppler with adequate vascularization of all renal tissue.

See the images of the renal allograft biopsy.

Figure 1. H&E, X100.

Figure 2. H&E, X400.

Figure 3. H&E, X400.

Figure 4. H&E, X400.

Figure 5. H&E, X200.

Figure 6. H&E, X200.

Figure 7. H&E, X200.

Figure 8. H&E, X400.

Figure 9. Methenamine-silver, X400.

Figure 10. Immunohistochemistry for SV40, X400.

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