Society of Diabetic Nephropathy Prevention Journal of Nephropathology 2251-8363 14 3 2025 07 01 Pregnancy complicated with acute interstitial nephritis and myocarditis in postpartum period; a case report e27591 e27591 10.34172/jnp.2025.27591 EN Fereshteh Saddadi https://orcid.org/0000-0003-4671-2962 Bahareh Marghoob https://orcid.org/0000-0002-1895-2785 Neda Najafi https://orcid.org/0000-0003-4133-8334 Hounaz Akbari https://orcid.org/0000-0003-4368-1048 Mohammad Hassan Fallahkohan https://orcid.org/0000-0002-3200-399X Journal Article 10.34172/jnp.2025.27591 2024 10 26 2024 12 20 The co-occurrence of postpartum acute interstitial nephritis (AIN) and myocarditis is a rare but serious complication of pregnancy following HELLP (hemolysis, elevated liver enzymes, and low-platelet) syndrome. We present the case of a 42-year-old woman who developed HELLP syndrome at the 31st week of gestational age. Termination of pregnancy and eight sessions of plasmapheresis were conducted. The patient exhibited acute kidney injury (AKI), dyspnea, bilateral pleural effusion, and 30% left ventricular (LV) ejection fraction. The diagnosis of AIN was established by kidney biopsy, while the post-partum cardiomyopathy (PPCM) was confirmed by cardiac magnetic resonance imaging (CMRI). The AKI and PPCM, in addition to hematologic abnormalities, were successfully resolved with intravenous methylprednisolone, followed by oral prednisolone.