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