We report a case of glomerular disease with both mesangial IgA and subepithelial IgG deposits in the allograft kidney. The patient was a 36 year-old man who had received a renal allograft 1 year previously. Fifteen days before admission, he discovered a microscopic hematuria without clinical evidences of allograft rejection. Light microscopy showed diffuse increase of mesangial matrix without mesangial cell proliferation. Capillary walls were diffusely and mildly thickened. Immunofluorescence microscopy demonstrated both granular deposits of IgA in the mesangium and IgG along the capillary walls. On electron microscopy, electron-dense deposits were identified not only in the mesangium but also on the epithelial side of the glomerular basement membrane.
Adult ; Case Report ; Glomerulonephritis, IGA/*immunology/pathology ; Human ; Immunoglobulin A/*analysis ; Immunoglobulin G/analysis ; Kidney/*immunology/pathology ; Kidney Transplantation/*immunology ; Male ; Transplantation, Homologous

Antiphospholipid syndrome nephropathy (APSN) is well documented in the literature as the renal involvement of the antiphospholipid syndrome (APS). A review of literature also shows that among antiphospholipid antibodies, lupus anticoagulant (LA) positivity is recognized as the strongest risk factor for APSN. In addition, APSN is also known to be associated with a poor functional outcome in the first posttransplant year. Therefore, it is a general belief that renal transplantation may be life threatening in APS patients. Furthermore, the presence of LA at the time of transplantation is particularly associated with a high rate of allograft APSN and the consequent poor transplantation outcomes. Here, we report the case that thrombotic acute kidney injury due to APSN after kidney transplantation can be successfully treated if anticoagulation therapy is timely applied with a prompt diagnosis.
Acute Kidney Injury ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome ; Humans ; Kidney ; Kidney Transplantation ; Lupus Coagulation Inhibitor ; Risk Factors ; Transplantation, Homologous ; Transplants