Fig. 1

Clinical data of Case 1. a ZHIB of the renal allograft showed no crystals (200X HE). b USG of performing renal graft biopsy. The renal volume was increased obviously than normal. c Renal graft biopsy on post-op day 46 revealed acute T cell-mediated rejection (TCMR, 2015 Banff 1A) and extensive tubular damage, with the presence of the emerging deposition of CaOx crystals in the allograft (200X HE and polarized light). d Sequencing analysis of GRHPR gene mutations identified in the patient’s family. Three missense mutations in the GRHPR gene were found: first, a C to T transversion (c.295C > T) in exon 4 resulting in p.(Arg99*), nonsense PV; second, a G to A transversion (c.512G > A) in exon 6 resulting in p.(Arg171His), missense VUS; third, a G to A transversion (c.211G > A) in exon 2 resulting in p.(Ala71Thr), missense VUS