Minimal change disease

Question 1

Does minimal change typically present as nephrotic or nephritic

Answer 1

Nephrotic

Question 2

The majority of cases of minimal change are idiopathic. TRUE/FALSE?

Answer 2

TRUE

Question 3

Some identifiable causes of Minimal change disease

Answer 3

drugs: NSAIDs, rifampicin
Hodgkin’s lymphoma, thymoma
infectious mononucleosis

Question 4

Pathophysiology of minimal change disease

Answer 4

T-cell and cytokine-mediated damage to the glomerular basement membrane

=> polyanion loss
=> reduction of electrostatic charge
=> increased permeability to serum albumin

Question 5

Clinical features or minimal change disease

Answer 5

• nephrotic syndrome
• normotension
• selective proteinuria
  (only albumin and transferrin leak through the glomerulus)

Question 6

Findings of minimal change on renal biopsy

Answer 6

• normal glomeruli on light microscopy

electron microscopy:
- fusion of podocytes
- effacement of foot processes

Question 7

Management of minimal change disease

Answer 7

corticosteroids

cyclophosphamide is the next step for steroid-resistant cases