Nephrotic Syndrome as the Initial Presentation of IgA Nephropathy: A Case Report

IgA nephropathy (IgAN) is the most common primary glomerulonephritis worldwide and is characterized by mesangial deposition of IgA, leading to glomerular inflammation and progressive renal injury.Although it most commonly presents with hematuria, nephrotic syndrome is an uncommon manifestation and may indicate more severe disease.We report the case of a 20-year-old woman who presented with hypertension and nephrotic syndrome.Initial renal biopsy demonstrated focal segmental glomerulosclerosis, while subsequent comprehensive histopathological evaluation, including immunofluorescence and electron microscopy, confirmed the diagnosis of IgAN.Despite optimized supportive management, the patient progressed to end-stage kidney disease requiring peritoneal dialysis.This case underscores the importance of comprehensive histopathological evaluation in patients with nephrotic syndrome and atypical biopsy findings to avoid diagnostic delay, guide appropriate therapeutic decisions, and improve prognostic assessment.