In a renal allograft, what is your diagnosis given these ultrastructural findings?
The EM picture shows glomerular basement membrane multilayering, which is consistent with chronic antibody mediated rejection. There was also peritubular capillary basement membrane multilayering, although no greater than 7 layers (Figures 2 and 3). By light microscopy, glomerulitis and peritubular capillaritis were also present. The patient had a previous biopsy, two years prior, that had already shown ABMR.
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