Coexistent De novo Membranous and Collapsing Glomerulopathies in the Allograft: Unusual Alloimmune Injury

We describe a kidney transplant recipient who presented 7 months after transplantation with nephrotic proteinuria and graft dysfunction, which on biopsy revealed two concomitant lesions: de novo membranous and collapsing glomerulopathies. While the index episode responded favorably to plasmapheresis and rituximab, repeat evaluation 4 months later showed an evolution of acute antibody-mediated rejection, along with the remnant pathologies.