A case of an ABO-incompatible renal transplant with abundant intratubular basement membrane immune deposits

: We present a case of a 30‐year‐old man who received an ABO‐incompatible renal transplant from his mother in 1996 after haemodialysis for 3 years. Although his renal function was stable, a renal biopsy was performed while he was in hospital for treatment of herpes zoster in 1999. Light microscopy p...

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Bibliographic Details
Published in:Clinical transplantation 2002-01, Vol.16 (s8), p.68-71
Main Authors: Shiozawa, Satoshi, Ichikawa, Tohru, Nakazawa, Koh, Ehara, Takashi, Shigematsu, Hidekazu
Format: Article
Language:English
Subjects:
ABO Blood-Group System - immunology
Adolescent
Basement Membrane - immunology
Biological and medical sciences
Combined surgery. Multiple transplantations
Complement C3 - analysis
Fluorescent Antibody Technique
Humans
immune deposit
Immunoglobulin G - analysis
Kidney - immunology
Kidney - ultrastructure
Kidney Transplantation - immunology
Kidney Tubules - immunology
Male
Medical sciences
renal transplantation
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
tubular basement membrane
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Summary:: We present a case of a 30‐year‐old man who received an ABO‐incompatible renal transplant from his mother in 1996 after haemodialysis for 3 years. Although his renal function was stable, a renal biopsy was performed while he was in hospital for treatment of herpes zoster in 1999. Light microscopy provided no evidence of obvious acute or chronic rejection but a double contour pattern was observed in many tubular basement membranes (TBM). Immunofluorescence microscopy revealed deposits of IgG and C3 on the TBM in the absence of glomerular deposition. Massive electron‐dense deposits were observed clearly by electron microscopy within TBM, revealing splitting and lamellation. This implies that the deposits resulted from the formation of immune complexes, but not from anti‐TBM antibody. Although the role of TBM deposits in tubular injury is controversial, careful observation of patients with such deposits may be required because of their potential ability to induce immune reactions.
ISSN:0902-0063
1399-0012
DOI:10.1034/j.1399-0012.16.s8.12.x