A Case of Fibrillary Glomerulonephritis – When You Least Expect It

ABSTRACT Malignancies can be associated with a wide range of glomerular diseases, with each malignancy having a predilection for a particular glomerular disease. Fibrillary glomerulonephritis (FGN) is usually associated with paraproteinemia and commonly presents as nephrotic range proteinuria with or without the full-blown nephrotic syndrome. Here, we report the case of a young male with left flank pain, found to have left adrenal adenoma, incidentally detected to have microscopic hematuria and nonnephrotic proteinuria whose renal biopsy done during adrenalectomy showed FGN. Indeed, this case demonstrates an unexpected diagnosis with an unusual presentation in the background of an uncommon malignancy. Although difficult to establish causation, it can be considered a unique case of adrenal adenoma-associated FGN.