6 Questions
What is the main characteristic of minimal change disease on light microscopy?
Minimal changes in the glomerular structure
What is the primary mechanism of proteinuria in minimal change disease?
Loss of glomerular anionic charge barrier
What is the most common presentation of minimal change disease?
Nephrotic syndrome
What is the typical finding on immunofluorescence microscopy in minimal change disease?
Negative or minimal deposits
What is the characteristic finding on electron microscopy in minimal change disease?
Fusion of podocyte foot processes
What is the typical age range affected by minimal change disease?
Children (80-90%) and adults (10-20%)
Study Notes
Minimal Change Disease
Definition
- A type of glomerulonephritis characterized by minimal changes in the glomerular structure on light microscopy
- Also known as lipoid nephrosis or nil lesion
Pathophysiology
- Immune-mediated disease, likely involving T-cell dysfunction
- Increased permeability of the glomerular capillary wall, leading to proteinuria
- Loss of glomerular anionic charge barrier, allowing albumin to pass through the glomerular filtration barrier
Clinical Features
- Most common cause of nephrotic syndrome in children (80-90%)
- Rare in adults (10-20%)
- Presents with:
- Nephrotic syndrome (proteinuria, edema, hypertension, lipiduria)
- Hematuria (microscopic or gross)
- Normal or slightly elevated serum creatinine
Diagnosis
- Renal biopsy:
- Light microscopy: normal or minimal changes
- Immunofluorescence: negative or minimal deposits
- Electron microscopy: fusion of podocyte foot processes
- Urinalysis: massive proteinuria (>3.5 g/24 hours)
- Serum albumin: low (<3 g/dL)
Treatment
- Steroids (prednisone) are the first-line therapy
- Response to steroids: 80-90% of patients achieve remission
- Relapse rate: 30-50%
- Additional immunosuppressive therapy (e.g., cyclophosphamide, mycophenolate mofetil) may be required in resistant or relapsing cases
Minimal Change Disease
Definition
- Characterized by minimal changes in glomerular structure on light microscopy
- Also known as lipoid nephrosis or nil lesion
Pathophysiology
- Immune-mediated disease involving T-cell dysfunction
- Increased permeability of glomerular capillary wall leads to proteinuria
- Loss of glomerular anionic charge barrier allows albumin to pass through glomerular filtration barrier
Clinical Features
- Most common cause of nephrotic syndrome in children (80-90%)
- Rare in adults (10-20%)
- Presents with:
- Nephrotic syndrome (proteinuria, edema, hypertension, lipiduria)
- Hematuria (microscopic or gross)
- Normal or slightly elevated serum creatinine
Diagnosis
- Renal biopsy:
- Light microscopy: normal or minimal changes
- Immunofluorescence: negative or minimal deposits
- Electron microscopy: fusion of podocyte foot processes
- Urinalysis: massive proteinuria (>3.5 g/24 hours)
- Serum albumin: low
Test your knowledge of minimal change disease, a type of glomerulonephritis characterized by minimal changes in the glomerular structure. Learn about its pathophysiology and clinical features.
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