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De novo lupus nephritis in a renal transplant recipient has not been previously reported. We present a transplant recipient with long-standing insulin-dependent diabetes mellitus who presented 9 years posttransplant with hematoproteinuria and acute renal failure. New findings of positive antinuclear antibody and double-stranded deoxyribonucleic antibody and renal histology findings consistent with lupus nephritis suggest a diagnosis of de novo systemic lupus erythematosis.
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