IgA‑codominant Post‑streptococcal Glomerulonephritis in a Patient with Type 1b Abernethy Malformation: A New Insight into the Pathogenesis

Post‑streptococcal glomerulonephritis is an immune complex‑mediated glomerulonephritis as a result of transient dysregulation of alternate complement pathway along with in situ immune complex formation. Here is a case of a young boy who developed acute nephritic syndrome following traumatic wound over his lower limb. Computed tomography (CT) abdomen is suggestive of Abernethy malformation. He underwent renal biopsy in view of rapidly worsening renal failure showing diffuse proliferative glomerulonephritis with predominant neutrophils, IgG (3+), IgA (3+), C3(3+), kappa (2+), and lambda (2+) on immunofluorescence, suggestive of immune complex glomerulonephritis favoring infection‑related glomerulonephritis. He was treated accordingly and showed signs of improvement with normalization of complements within 4 weeks of insult. As the genesis of infection‑related glomerulonephritis here in this case is complex due to the hepatic malformation where there is mixing of blood between the systemic and portal systems, the narrative is that congenital anomaly too has a say in the pathogenesis of infection‑related glomerulonephritis as it happened in our case.