Coexistence of autoimmune thyroiditis and iga nephropathy in a young adult male: expanding the spectrum of thyroid-related renal involvement

Background: Autoimmune thyroiditis (Hashimoto’s thyroiditis) is the most common cause of hypothyroidism in iodine-sufficient areas and may coexist with other autoimmune disorders due to shared genetic and immune mechanisms1,2,3,4. Renal involvement is uncommon but can include membranous nephropathy, minimal change disease, and rarely IgA nephropathy (IgAN)5,6,7. IgAN is the most frequent primary glomerulonephritis worldwide, characterized by mesangial IgA deposition, presenting with hematuria, proteinuria, and variable renal dysfunction8,9,10. Its association with autoimmune thyroiditis is rarely reported11,12,13,14 and may involve shared autoimmune pathways or antigenic cross-reactivity15. Awareness of this overlap can aid early diagnosis and management. Case Presentation: A 26-year-old male presented with progressive shortness of breath and gross hematuria for 15 days. He had a prior diagnosis of autoimmune thyroiditis made 8 months earlier, for which he was on regular thyroxine therapy. Physical examination revealed pallor, bilateral pedal edema, and mild hypertension. Laboratory investigations showed hematuria, proteinuria, elevated serum creatinine, and normal complement levels. Thyroid function tests were consistent with treated hypothyroidism. Renal biopsy demonstrated mesangial proliferation with dominant IgA deposition on immunofluorescence, confirming IgA nephropathy4. Conclusion: The coexistence of autoimmune thyroiditis and IgA nephropathy is rare but clinically significant, suggesting a possible shared autoimmune pathogenesis5,6. Early recognition is important for appropriate management and monitoring of renal function in patients with autoimmune thyroid disease.