17 June 2023
: Case report 
A 78-Year-Old Man with Chronic Kidney Disease and Monoclonal Gammopathy Who Developed Post-Transplant C3 Glomerulopathy – Recurrence or De Novo? A Case Report and Literature Review
Challenging differential diagnosis, Rare coexistence of disease or pathology
María Carmen Ruiz-Fuentes
1ABEF*, Mercedes Caba-Molina 2D, Aurora Polo-Moyano1B, Magdalena Palomares-Bayo1B, Pilar Galindo-Sacristan1B, Carmen De Gracia-Guindo 1E
DOI: 10.12659/AJCR.939726
Am J Case Rep 2023; 24:e939726
Table 2. Histology.
| One epithelial crescent | |
| Mild segmentary and focal increase of mesangial cells number | |
| Tubules: loss of brush edging, pyknosis and nuclear irregularity, cell release, epithelial flattening, and some signs of mitosis. Some cylinders with a hematic component | |
| Glomerulitis | g0 |
| Interstitial inflammation | i0-1 |
| Tubulitis | t0 |
| Mild capillaritis | ptc1 |
| Chronic damage of interstitial fibrosis | ci1 |
| Mild tubular atrophy (“thyroidization”) | ct1 |
| Intimal thickening | cv2 |
| C4d | Negative |
| SV40 | Negative |
| Congo red | Negative |
| C3 ++/+++. Global deposit, scarce but very intense deposit in mesangial and paramesangial areas | |
| C4d ++ presence in glomerulus, in 2 of the 3, negative in peritubular capillaries | |
| IgA and IgG traces, and kappa and lambda chains in the glomerulus | |
| Positivity for IgA, kappa and lambda in tubular cylinders | |