What does this research mean for the field?

Progressive graft dysfunction in renal transplant recipients can present significant diagnostic complexity when accompanied by concurrent gastrointestinal symptoms, medication toxicity, chronic allograft injury, and unexpected neoplasms. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To report a complex case of progressive renal allograft dysfunction complicated by concurrent gastrointestinal symptoms, immunosuppression toxicity, and an unexpected duodenal neuroendocrine tumor.

September 1, 2026Open Access

A Journey Through Renal Transplantation – From Stable Graft Function to an Unexpected Duodenal Neuroendocrine Tumor

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To report a complex case of progressive renal allograft dysfunction complicated by concurrent gastrointestinal symptoms, immunosuppression toxicity, and an unexpected duodenal neuroendocrine tumor.
Clinical, histopathological, and radiological evaluation of a 44-year-old male living-related renal transplant recipient presenting two years post-transplant with declining graft function and gastrointestinal bleeding.
Diagnostic workup included endoscopic duodenal biopsy with synaptophysin and Ki-67 staining, Ga-68 DOTATATE PET-CT, and allograft renal biopsy.
Duodenal biopsy identified a well-differentiated grade 1 neuroendocrine tumor (synaptophysin-positive, Ki-67 1–3%), with Ga-68 DOTATATE PET-CT confirming localized somatostatin-receptor-expressing lesions in D3/D4 segments.
Renal allograft biopsy demonstrated IgA nephropathy with 40% interstitial fibrosis and tubular atrophy without evidence of acute rejection, prompting replacement of mycophenolate mofetil with azathioprine, tacrolimus dose reduction, and initiation of long-acting octreotide.

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Implication

Case report reveals duodenal neuroendocrine tumor and IgA nephropathy in a kidney recipient, highlighting diagnostic overlap between drug toxicity and malignancy.

Cite This Study

Manjusha Yadla2 Saraswathi Yashaswini1* (2026) studied this question.

synapsesocial.com/papers/6a96914e7a497a6ca291f46e https://doi.org/10.5281/zenodo.22160126

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Implication

Case report reveals duodenal neuroendocrine tumor and IgA nephropathy in a kidney recipient, highlighting diagnostic overlap between drug toxicity and malignancy.

A Journey Through Renal Transplantation – From Stable Graft Function to an Unexpected Duodenal Neuroendocrine Tumor

Key Points

Discussion

Implication

Cite This Study

A Journey Through Renal Transplantation – From Stable Graft Function to an Unexpected Duodenal Neuroendocrine Tumor

Key Points

Discussion

Implication

Cite This Study

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