Minimal change disease associated with IgA nephropathy “a rare clinical spectrum”: Case report

Abstract

Minimal change disease (MCD) is one of the main causes of idiopathic nephrotic syndrome, manifesting with intense proteinuria leading to edema and intravascular volume depletion, characterized by the absence of alterations in light microscopy and the presence of effacement of the podocyte processes in electron microscopy. Although the cause is unknown, it is believed that due to an immunologic dysregulation and modifications of the podocyte and of the proteins that constitute the cytoskeleton of this one and of the filtration diaphragm, generating an alteration in the integrity of the glomerular basement membrane and, therefore, conditioning the presence of proteinuria. IgA nephropathy (IgAN) is the most common mesangial proliferative glomerulopathy in developed countries and one of the main causes of chronic kidney disease and renal failure in Asian population, characterized by the presence of mesangial IgA deposits. The clinical presentation is extremely variable, ranging from isolated dysmorphic microhematuria to chronic deterioration of renal function. We present a rare case of these two primary glomerulopathies concomitantly in one patient. This is intended to increase medical sensitivity in the diagnosis of the coexistence of these two primary glomerulopathies as atypical presentations in clinical practice.