title: A case of transplant glomerulopathy early after kidney transplantation.
abstract: Transplant glomerulopathy (TG) has commonly been described as a late manifestation of allograft injury, occurring years after renal transplantation. We describe herein a patient who developed TG early (49 days) after kidney transplantation (KTx).
  
  
  METHODS
  A 44-yr-old woman received a second living-related KTx from her younger brother in October 2009. Pre-transplant donor-specific anti-human leukocyte antigen antibodies (DSA) were positive for both class I and class II. During the renal transplant operation, she suffered from hyperacute antibody-mediated rejection (AMR) and intravenous immune globulin therapy was immediately performed. Once hyperacute AMR was resolved, accelerated acute AMR occurred on the first post-transplant day (PTD). The renal allograft biopsy performed on PTD 19 diagnosed acute AMR type II. The renal allograft biopsy performed on PTD 49 showed focal lesions of double contours of glomerular basement membranes in some glomeruli. Interstitial fibrosis showed a strong, diffuse staining of C4d in peritubular capillaries (PTCs). The DSA examined on PTD 39 were still positive for both class I and class II. From these histopathological findings of TG, C4d deposition in PTC and presence of circulating DSA, we diagnosed this case to have c-AMR.
  
  
  CONCLUSIONS
  TG might be recognized in early after KTx.
authors.affiliation: Department of Urology, Tokyo Women's Medical University, Tokyo, Japan. houichi@aol.com
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Shimizu
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishida
authors.forename: Tatsu
authors.initials: T
authors.lastname: Tanabe
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirakawa
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tanabe
authors.forename: Kazuho
authors.initials: K
authors.lastname: Honda
authors.forename: Junki
authors.initials: J
authors.lastname: Koike
mesh_terms: D000328:Adult; D015935:Complement C4b / Q000032:analysis; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000209:etiology*; D006084:Graft Rejection; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D007678:Kidney Glomerulus / Q000473:pathology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D010446:Peptide Fragments / Q000032:analysis
chemical_list: D007518:Isoantibodies; D010446:Peptide Fragments; D015935:Complement C4b; C032261:complement C4d