An Unexpected Alliance: Coexisting Alport Syndrome and IgA Nephropathy in the Setting of Socioeconomic Barriers

Background: Alport syndrome and IgA nephropathy (IgAN) are distinct glomerular diseases that may present with overlapping symptoms, including hematuria and proteinuria. Their coexistence is rare and can complicate diagnosis, primarily when socioeconomic barriers to care exist. Case report: A 50-year-old Nepali male with persistent proteinuria and microscopic hematuria was found to have coexisting IgAN and autosomal dominant Alport syndrome, confirmed through renal biopsy and genetic testing. Management was limited by financial constraints that prevented access to advanced therapies. Urological evaluation showed congestive hemorrhagic cystitis secondary to benign prostatic enlargement contributing to hematuria. Conclusion: This case highlights the diagnostic complexity and management challenges associated with dual nephropathies, underscoring the importance of genetic testing and socioeconomic factors in the delivery of care.