Minimal change disease

Question 1

What is it a cause of/how does it usually present?

Answer 1

As nephrotic syndrome

Question 2

Who is it more common in?

Answer 2

Children

Question 3

What is the main cause?

What other possible causes?

Answer 3

Idiopathic

Others:

• Drugs: NSAIDs, rifampicin
• Hodgkin’s lymphoma
• EBV

Question 4

What is the pathophysiology?

Answer 4

Damage to GBM = polyanion loss = increased glomerular permeability to serum albumin

Question 5

How does it present?

What is highly selective proteinuria?

Answer 5

Nephrotic syndrome
Normotension
Highly selective proteinuria - only intermediate-sized proteins e.g. albumin and transferrin leak through

Question 6

What is seen on renal biopsy?

Answer 6

Light microscopy = normal

Electron microscopy = fusion of podocytes and effacement of foot processes

Question 7

Do you need to do a biopsy?

Answer 7

No

Question 8

How is it MX?

Answer 8

Corticosteroids

Most are steroid-responsive

Question 9

What is given if pt doesn’t respond to steroids?

And what is this called?

Answer 9

Cyclophosphamide

Steroid-resistant

Question 10

What is the prognosis?

Answer 10

1/3 have one episode only
1/3 have frequent relapses
1/3 have frequent relapses which stop before adulthood