Bagai S, et al. - Since early identification and prompt treatment can fully reverse the kidney injury in cases with adenine phosphoribosyl transferase (APRT) deficiency—a rare genetic form of kidney stones and/or kidney failure defined by intratubular precipitation of 2,8 dihydroxyadenine crystals—researchers here report the case of a renal transplant recipient who was 44 year old Indian male, who got admitted with acute graft dysfunction. Consistent with APRT deficiency, light brown refractile intratubular crystals with surrounding giant cell reaction were evident on graft biopsy. Following the receipt of allopurinol and hydration, an improvement was seen in the patient. This case demonstrates APRT as a reversible cause of crystalline nephropathy. Since there are therapeutic implications of timely diagnosis, therefore, a high index of suspicion is needed to make the correct diagnosis.