Minimal Change Disease

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Introduction

Minimal change disease is the most common cause of nephrotic syndrome in children under 6 years of age, affecting more males than females.

a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.

Cause of minimal change is unknown. Potential causes include post-allergic reaction, circulating immune complexes, or altered T-cell immunity.

No significant changes are seen under the light microscope, hence the name.

Electron microscopy shows fusion of podocytes, with effacement of foot processes.

Treatment involves corticosteroid therapy and ciclosporin or cyclophosphamide.

Prognosis is good in children but variable in adults. End-stage renal failure can occur on occasion.

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