MINIMAL CHANGE DISEASE

MINIMAL CHANGE DISEASE

  • It is also "minimal change glomerulopathy" or nil disease
  • It is a disease affecting the kidneys which causes a nephrotic syndrome                                 most common cause of nephrotic syndrome in children
  • common age 2 - 8 yrs




CLINICAL FEATURES:

  • Puffy eyes
  • vulval edema/scortal edema, pedal edema
  • weight gain ++
  • Oncotic pressure decreased - albumin decreased
- Selective proteinuria
- pleural effusion bilateral(Transudative) - dyspnea
- Ascites - Abdominal girth increased, everted umbilicus

WORKUP:
  • BUN/creatinine - normal
  • urine microscopic - Oval fat bodies
  • 24hrs urine protein increased
  • urine protein electrophoresis
  • C3 levels normal/decreased
  • kidney biopsy - light microscopic - normal
electron microscopic - podocytes - foot process effacement


TREATMENT:
Steroid
- prednisolone 8weeks (Taper dose), good response and hence called STEROID RESPONSIVE NEPHROTIC SYNDROME
- sudden withdrawal cause - Addisonian crisis


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