Figure 1725

Histologic slide of a biopsy from a patient with recurrent immunoglobulin A (IgA) nephropathy. This patient developed proteinuria 9 months after receiving a cadaveric allograft. The biopsy shows features of recurrent IgA disease with mesangial expansion and a glomerular tuft adhesion to Bowman's capsule. Immunohistology confirmed deposition of IgA in the mesangium. At the earliest stages of recurrence, mesangial IgA and complement C3 are detectable by 3 months after transplantation, with electron-dense deposits in the paramesangium but normal appearance on light microscopy. In patients with progressive renal dysfunction, crescents often are found in the glomerulus.

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