A 28-year-old woman presents with frothy urine and bilateral pedal oedema. Urine dipstick shows 4+ protein, no blood. 24-hour urine protein is 5.2 g. Serum albumin is 2.1 g/dL. Serum creatinine is 0.8 mg/dL. Complement levels are normal. ANA and anti-dsDNA are negative. Which diagnosis is MOST likely in this age group without an underlying systemic cause?

• A Membranous nephropathy
• B Lupus nephritis
• C Focal segmental glomerulosclerosis
• D Minimal change disease ✓

Explanation

Minimal change disease is the most common cause of primary nephrotic syndrome in children and young adults under 30, presenting with selective proteinuria and normal complement levels. Membranous nephropathy peaks in middle age (40-50 years). FSGS can present at any age but is less common than minimal change in this young demographic. Lupus nephritis is excluded by negative autoantibodies.

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.