There is ample evidence suggesting that hepatitis C virus (HCV)-associated autoimmunity plays a role in a broad spectrum of autoimmune diseases, which are usually overlooked. We report on a case of nephrotic syndrome, palpable purpura, cryoglobulinemia, hypocomplementemia, and acute renal failure complicated by immune complex glomerulonephritis (GN). The patient is a 64-year-old man with HCV infection, who was initially considered to present only an HCV-associated cryoglobulinemic GN. However, renal biopsy revealed a "full house" immune complex crescentic GN, which led to our subsequent investigation. The attending clinicians faced what is a common dilemma, where an HCV-associated autoimmune disease inevitably switches to a lupus-like GN. Hence, we also discuss treatment.