case_images: PMC5872611_01
case_images: Retrograde cystography showing massive ureterovesical reflux and hydronephrosis.
case_images: CRIN2018-1727986.001.jpg
case_images: PMC5872611_01_CRIN2018-1727986.001.jpg
case_images: fig1
case_images: Massive bilateral ureterohydronephrosis secondary to grade V ureterovesical reflux associated with a trabeculated bladder was evidenced (Figure 1).
case_images: Histological examination showing thrombotic microangiopathy in a kidney biopsy from renal allograft at day 120 (hematoxylin and eosin). Microthrombi and lucent deposits (arrowheads) are observed in the glomerulus at the right side, with obstruction of a nearby arteriole by eosinophilic material (arrow). Notice the unaffected glomerulus on the left side of the microphotograph. There is no evidence of acute antibody-mediated rejection according to the 2015 Banff classification (g0, ptc0, and no C4d deposit by immunofluorescence (not shown)).
case_images: CRIN2018-1727986.002.jpg
case_images: PMC5872611_01_CRIN2018-1727986.002.jpg
case_images: fig2
case_images: A second kidney biopsy showed pathognomonic features of thrombotic microangiopathy (including a preglomerular arteriole of one glomerulus obstructed by a fresh thrombus and mesangiolysis, without argument for antibody-mediated rejection) (Figure 2).