Nephrotic- Minimal Change Disease Flashcards
What is MCD?
Relatively benign disorder that is the most frequent cause of nephrotic syndrome in children but less common in adults.
What age groups are most susceptible to MCD?
Very old and the very young
What is another name for MCD?
Lipid Nephrosis
Where is the primary defect in MCD?
Podocytes. Effacement and detachment but NO DEPOSITS.
How do podocytes appear under light microscopy in MCD?
Normal
Which gender of children is most likely to have MCD?
Male > Female
What part of the renal anatomy is primarily affected in MCD?
Glomerulus.
What disease may precipitate MCD?
- Hodgkin disease
- Thymoma
- T-Cell Leukemia
- Use of NSAIDs of Interferon-alpha
What are the immunoflurescence findings in MCD?
Negative
What is the most common finding in MCD?
Insidious onset of edema and nephrotic syndrome.
What are the BP findings in MCD?
Normal usually
What are the renal function findings in MCD?
Normal, there is occassinal acute kidney injury
What is distinctive about the proteinuria in MCD?
Highly selective for Albumin
How is the diagnosis of MCD made?
Renal Biopsy with electronmicroscopy.
What usually precedes MCD?
Respiratory infection and routine immunization
What is the pathogenesis of MCD?
Idiopathic but there is evidence that T-Cell (TH2) cytokines cause the GBM to lose its negative charge and thus the proteinuria
What is the treatment for MCD?
Corticosteroids have be shown to be effective.
How long does treatment last in those cases of MCD sensitive to steroids?
~6 weeks
In those patients where steroid therapy fails what are the most prescribed agents in MCD?
Cyclophosphamide, cyclosporine, tacrolimus
What would poor response to steroids in children indicate?
Possible other etiologies
What is MCD most likely to progress to?
FSGS
