Case ReviewsEarly Renal Allograft Dysfunction: Report of a Case With Ultrastructural StudiesTroxell, Megan L. MD, PhD*; Aziz, Feroz MD†; Houghton, Donald C. MD*Author Information From the *Department of Pathology, †Division of Nephrology and Hypertension, Department of Medicine, Oregon Health & Science University, Portland, OR. Reprints: Megan L. Troxell, MD, PhD, Department of Pathology, L471, 3181 SW Sam Jackson Park Rd, Portland, OR 97239. E-mail: [email protected]. The authors have no funding or conflicts to declare. This case was presented on March 18, 2012, at the USCAP annual meeting in Vancouver, BC. Pathology Case Reviews: November/December 2012 - Volume 17 - Issue 6 - p 245-247 doi: 10.1097/PCR.0b013e3182759204 Buy Metrics Abstract Early renal allograft dysfunction is often associated with acute rejection (cellular or antibody mediated) or graft injury due to ischemia or surgical complications. Correlation of clinical, laboratory, and imaging studies are crucial in the assessment of patients with early graft dysfunction. Renal allograft biopsy is often necessary for diagnosis and to guide definitive therapy. We present a case of early graft dysfunction with an unusual clinical presentation and histologic picture. A high index of clinical suspicion along with electron microscopic studies led to the diagnosis. © 2012 Lippincott Williams & Wilkins, Inc.