Acute hepatitis E virus infection as a trigger for postinfectious IgA nephropathy: A rare case report.

rationaleIgA nephropathy (IgAN) is most often idiopathic but may occur following infections. While associations with hepatitis B and C are recognized, its link with acute hepatitis E virus () infection is rarely described and remains poorly understood. PATIENT CONCERNS: A 37-year-old male presented with fever, sore throat, vomiting, generalized weakness, and dark-colored urine for 2 days. DIAGNOSES: Laboratory evaluation showed markedly elevated liver enzymes, hyperbilirubinemia, and acute kidney injury. Hepatitis E IgM was positive. Renal biopsy demonstrated postinfectious IgA nephropathy with mesangial hypercellularity and moderate acute tubular injury.

interventionsThe patient received supportive therapy, including intravenous fluids, hemodialysis, plasma exchange, and corticosteroid treatment with intravenous methylprednisolone followed by an oral prednisolone taper. OUTCOMES: Renal function progressively improved. By 3 months, serum creatinine decreased from 703 µmol/L at admission to 135 µmol/L, with resolution of symptoms and no recurrence of hematuria or renal impairment. LESSONS: This case suggests that acute HEV infection may act as a trigger for postinfectious IgA nephropathy. Clinicians should consider IgAN in patients with HEV who develop renal dysfunction, as timely recognition and management can substantially improve outcomes.