Minimal Change Disease

Question 1

Minimal change disease also called

Answer 1

Liphoid nephrosis

Question 2

Prevalence of MCD

Answer 2

90% of nephrotic syndrome in children

10-15% of nephrotic syndrome in adults

Question 3

Peak age of MCD

Answer 3

2-7 years

Boys (mc)

Question 4

Glomerular disease are mostly a window in which we see

Answer 4

Systemic disease

Question 5

Secondary causes for MCD

Answer 5

Drugs

NSAIDS
Interferon alpha
Rarely (lithium, gold)

Allergy and immunization
(Atopic rhinitis, allergic dermatitis, broncjial ashtma, house dust, pollen, insect)

Malignancy
(Hodgkins disease, cutaneous T cell lymphoma)

Question 6

Primary MCD presentation

Answer 6

100% present with nephrotic syndrome

Question 7

Patient with nephrotic syndrome is not considered MCD when he has

Answer 7

HTN
HEMATURIA
INCREASED SERUM CREATININE

Question 8

Bipsy findings of MCD

Answer 8

Light microscopy amf immunoflurocence is normal

IGM +ve– IGM nephropathy– progress to CKD

ELECTRON MICROSCOPE
Effacement of foot process of podocytes

Question 9

Pathologically

Answer 9

Increased CD 80 expression
Increased angiopoiten like -4 expression

Question 10

Minimal change disease has no risk for CKD because there is

Answer 10

No reduction in Podocytes

Only injury to Podocytes

Question 11

Specific management of MCD

Answer 11

In child

60mg /m2/ day oral prednisolone Or
2mg/kg/day
Fulldose one shot in morning
Fulldose for 6 weeks
Taper and stop another 6 weeks

Adult

1mg/kg/day

Question 12

Total duration of therapy to MCD is

Answer 12

12 weeks

6 weeks full dose
6 weeks tapering dose

Question 13

Remission for MCD child (90%)

Answer 13

Urine albmin mil for 3 consecutive days

Question 14

children resistance to MCD treatment (5-10%)

Answer 14

Protenuria persisting despite full dose of steroids for 4 weeks in a child

In adults 4 months