IgA Nephropathy in a Patient with Tularemia: Causality or Coincidental Association?

Immunoglobulin A (IgA) nephropathy is the most common primary glomerulonephritis. Oropharyngeal tularemia is a zoonotic infection caused by Francisella tularensis. To the best of our knowledge, no previous report has documented F. tularensis as a potential cause of IgA nephropathy. Here, we describe a case of IgA nephropathy occurring in the context of oropharyngeal tularemia. A 47-year-old man developed dark-colored urine a few days after the onset of upper respiratory symptoms. Kidney biopsy confirmed IgA nephropathy in the setting of acute kidney injury. Treatment with prednisolone and cyclophosphamide, in combination with tularemia-specific therapy, led to clinical improvement. This case highlights a possible association between tularemia and IgA nephropathy, warranting further investigation into the underlying mechanisms. Graphic Abstract: Graphic Abstract.