PMC5872611_01
Retrograde cystography showing massive ureterovesical reflux and hydronephrosis.
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fig1
Massive bilateral ureterohydronephrosis secondary to grade V ureterovesical reflux associated with a trabeculated bladder was evidenced (Figure 1).
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)).
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fig2
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).