Minimal change disease (MCD):

Question 1

Q: What is the most frequent cause of nephrotic syndrome in children?

Answer 1

Minimal Change Disease (MCD)

Question 2

What age group is particularly affected by MCD?

Answer 2

Children, especially those between 2 to 6 years old.

Question 3

What is the pathogenesis of MCD?

Answer 3

It involves podocyte damage, effacement of foot processes, and a potential dysfunction of T-cell function.

Question 4

What are the morphological changes observed in MCD?

Answer 4

A: Light Microscopy (LM): Nil change

Also, PCT (proximal convoluted tubules) are laden with protein and lipids, referred to as lipoid nephrosis

Immunofluorescence (IF): Nil

Electron Microscopy (EM): Effacement of foot processes

Question 5

What are the clinical features of MCD?

Answer 5

A: - Insidious onset of nephrotic syndrome

•	Highly selective proteinuria, primarily albumin
•	Possible association with upper respiratory tract infections (URTI) or immunization
•	Over 90% respond to a short course of corticosteroid therapy

Question 6

What is the prognosis for children with MCD?

Answer 6

Excellent

•	Proteinuria might recur
•	Some patients might become steroid dependent or steroid resistant
•	Less than 5% develop chronic renal failure (CRF) after 25 years

Question 7

What is the prognosis for adults with MCD?

Answer 7

Good

•	Slower response to steroids
•	More common relapses