SUMMARYWe describe a child with acute post-streptococcal glomerulonephritis (APSGN), who developed a very low plasma high-density lipoprotein cholesterol (α-lipoprotein) in association with transient but massive proteinuria. The hypoalphalipoproteinaemia resolved spontaneously concomitant with the remission in proteinuria and the patient had a complete clinical recovery. Urinary loss of apolipoprotein A1 may have contributed to the hypoalphalipoproteinaemia. To our knowledge, this has not been reported previously in APSGN. BACKGROUND