A 5-year-old boy presents with periorbital oedema and scrotal swelling. Urinalysis shows 4+ proteinuria without haematuria. Serum albumin is 1.9 g/dL and cholesterol is 320 mg/dL. What is the MOST likely underlying diagnosis?

• A Focal segmental glomerulosclerosis
• B Minimal change disease ✓
• C Membranous nephropathy
• D Membranoproliferative glomerulonephritis

Explanation

Minimal change disease accounts for roughly 80 to 90 percent of nephrotic syndrome in children under 10 years, typically presenting with selective albumin-heavy proteinuria and no haematuria. It responds dramatically to corticosteroids, so biopsy is reserved for steroid-resistant cases. The best distractor, FSGS, becomes the leading primary cause only in adolescents and adults, particularly those of African descent, and usually carries haematuria, hypertension, and a poorer steroid response.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.