Unmasking Renal Amyloidosis: Nephrotic Proteinuria in the Wake of Pleural Tuberculosis

Background: Secondary (AA) amyloidosis is an infiltrative disease resulting from chronic inflammatory states such as infections, arthritis, or malignancies. Child presenting as Nephrotic proteinuria with histological evidence of De novo amyloidosis occurring is rare. Case: We report the case of a 15-year-old boy who developed pleural tuberculosis in 2018 completed 6 months of anti-TB therapy. In 2022, he presented with asymptomatic nephrotic range proteinuria and renal dysfunction. Kidney biopsy revealed features consistent with AA amyloidosis confirmed by histopathology and immunohistochemistry. Conclusion: This case highlights the rare occurrence of de novo AA amyloidosis following prior TB infection. Long-term follow-up with past infections is essential for early detection of such complications.