Minimal Change Disease Quiz

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.