CLINICAL HISTORY
A 62-year-old male presented with end stage renal disease secondary to systemic lupus erythematosus (SLE). He underwent a cadaveric renal transplant and was on standard immunosuppression. One month post transplantation he developed biopsy-proven acute cellular rejection. Six months later his creatinine began to rise, and a kidney biopsy showed chronic rejection and recurrence of lupus nephritis. The dosage of steroids was increased. The clinical condition of the patient improved. Recently, his serum creatinine was increasing again. A kidney biopsy was performed.
LABORATORY DATA
Noncontributory.
ANCILLARY STUDIES
Noncontributory.
GROSS PATHOLOGY
Noncontributory.
MICROSCOPIC PATHOLOGY
Light Microscopy
- Markedly enlarged tubular epithelial cells with large, smudgy nuclei and chromatin basophilia.
- Intranuclear inclusion.
- Tubule-interstitial nephritis with predominant lymphocytes.
Electron Microscopy
Nuclear inclusion bodies consisting of crystalline arrays of naked, round, electron-dense particles (40-50 nm).
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