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December 21, 2021

Diagnose This (December 20, 2021)

This is the biopsy of a 68-year-old female with a history of bone marrow transplant and AKI. What is your diagnosis?

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The biopsy shows acute interstitial nephritis with linear tubular basement membrane staining for IgG restricted to proximal tubules. These features are diagnostic of anti-TBM interstitial nephritis, a rare disease associated with autoantibodies to a non-collagenous 54-58 kD protein in proximal TBMs.

 

Additional Reading 

AJKD Atlas of Renal Pathology: Anti–Tubular Basement Membrane Antibody Disease