E CASE 1Case For Discussion

DEPARTMENT OF PATHOLOGYARMED FORCES MEDICAL COLLEGE,

PUNE

• A 23 year old male, underwent live related renal allograft transplant 3 years ago

• 1 episode of rejection in the initial post-transplant period (Acute cellular rejection and AMR) which were successfully managed with a return of serum creatinine to baseline (1.3 mg/dL).

• He now presented with nephrotic range proteinuria and serum creatinine of 1.5 mg/dL.

• Kidney biopsy was performed.

IgG, X40 C3, X40

IgM, X40 IgA, X40 C1q, X40

C4d, X 40

C4d, X 20