Biopsy-proven dengue virus-associated IgA nephropathy and interstitial nephritis with viral RNA detected in kidney tissue.

BACKGROUND

Dengue virus infection can cause kidney involvement, but biopsy-confirmed cases with both glomerular and tubulointerstitial lesions and molecular evidence of viral presence are rare.

CASE PRESENTATION: A previously healthy 34-year-old man developed fever and dark urine after returning from Vietnam. He presented with acute kidney injury, nephrotic-range proteinuria, hematuria, and elevated aminotransferases. Kidney biopsy revealed IgA nephropathy (Oxford M1E0S0T0C0) with acute interstitial nephritis and granulomatous inflammation. Dengue virus serotype 2 RNA was detected in blood and renal tissue by tNGS. With supportive treatment, renal function, proteinuria, and hematuria completely resolved within one month.

CONCLUSION

Dengue infection may trigger concurrent glomerular and tubulointerstitial immune-mediated kidney injury. Molecular detection of viral RNA in renal tissue provides evidence of renal involvement.