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cing permanent pacemaker implantation, neurological events, TIA, major vascular complications, and re-intervention. Nutcracker and superior mesenteric artery (SMA) syndrome share the same pathogenesis, but the simultaneous occurrence of both diseases is quite rare. A combination of the nutcracker syndrome and IgA nephropathy has previously been reported. Herein, we report what we believe is the first case of coexisting nutcracker and SMA syndrome in a patient with IgA nephropathy. A 15-year-old Chinese boy who was diagnos