A 28-year-old man presents with peripheral oedema, frothy urine, serum albumin 2.1 g/dL, and 24-hour urine protein 6.8 g. Complement levels are normal. Renal biopsy shows podocyte foot process effacement on electron microscopy with no immune deposits on immunofluorescence. The diagnosis is:
- A Focal segmental glomerulosclerosis
- B Membranous nephropathy
- C Minimal change disease ✓
- D IgA nephropathy
Correct answer: C. Minimal change disease
Explanation
Minimal change disease (MCD) is defined by diffuse podocyte foot process effacement on electron microscopy with no deposits on immunofluorescence (IF is negative or non-specific), which is its hallmark distinguishing feature. It presents with nephrotic syndrome and is the most common cause of nephrotic syndrome in children and a significant cause in adults. FSGS shows segmental scarring on light microscopy. Membranous nephropathy shows subepithelial deposits with spikes on silver stain and granular IgG/C3 on IF. IgA nephropathy has mesangial IgA deposits on IF.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.