• Transplant 3 years back.
• Presented with anasarca and proteinuria,
• UACR:3068mg/gm
• Baseline Creatinine 1.2-1.3 mg.

Biopsy Diagnosis: Proliferative picture with MPGN pattern injury

DIF: IgG-Kappa restricted glomerular staining

History of Native Biopsy: 9 years back: Biopsy proven MPGN, But DIF was not done. So probably this is a recurrence of PGNMID!

Points of discussion

DIF is an essential and integral part of both Native and Transplant biopsies! Without DIF, Diagnosis is incomplete, plus without identifying the Light microscopic features correctly, you can not reach to a correct Diagnosis!

PGNMID Recurrence in Transplant- Renal Path Labs