Utility of Iron Staining in Identifying the Cause of Renal Allograft Dysfunction in Patients with Sickle Cell Disease

Figure 2

Acute tubular injury caused by type 2 antibody-mediated rejection in the allograft kidney. (a) Light microscopy showed a glomerulus with lobular configuration and focal fibrin thrombi (arrow). Renal tubules are mildly dilated with mild tubulitis. Interstitial mononuclear infiltrate is also seen (hematoxylin and eosin, original magnification ×100). (b) C4d diffusely positive in peritubular capillaries and glomerular capillary loops (original magnification ×200). (c) Iron staining is essentially negative (original magnification ×100). (d) Electron photomicrograph showed double contoured glomerular capillary loops with lucency and subendothelial deposit of fibrin (arrow), consistent with thrombotic microangiopathy (original magnification ×4000).

(a) HE

(b) C4d

(c) Iron

(d) EM