A Rare Case of Diffuse Alveolar Hemorrhage in the Setting of IgA Nephropathy, Vasculitis and Atypical Hemolytic Uremic Syndrome in a Previously Healthy Young Adult

IgA Nephropathy, also known as Berger disease, can precipitate acute renal failure in patients. IgA Nephropathy (IgAN) is deposition of protein from IgA into the renal tissue with subsequent renal dysfunction. IgA vasculitis (IgAV) is another condition where similarly the protein of IgA is deposited into the vessels. There are some cases of co-existing atypical hemolytic uremic syndrome (aHUS) with IgAN. However, rare combinations seen with all three IgAN, IgAV, and aHUS without any pre-existing conditions nor medical history. Patients that develop any one of these conditions are looking at life long changes with hemodialysis (HD) and organ transplants being the definitive treatment. Hemolytic Uremic Syndrome (HUS) is a multitude of thrombocytopenia, microangiopathic hemolytic anemia, and renal failure. In this case, we focus on 27 year old male with the complement overactivation type, known as aHUS, where omplement regulatory proteins that are attacked by autoantibodies. Precipitating events or triggers are needed for dysregulation of these proteins leading to fulminant renal failure.