A 6-year-old boy presents with periorbital edema, massive proteinuria (8 g/day), hypoalbuminemia, and hyperlipidemia. Renal biopsy shows normal glomeruli on light microscopy, negative immunofluorescence, and foot process effacement on electron microscopy. First-line treatment is:
- A Cyclophosphamide
- B Prednisolone ✓
- C Mycophenolate mofetil
- D Rituximab
Correct answer: B. Prednisolone
Explanation
The biopsy findings describe minimal change disease (MCD), the most common cause of nephrotic syndrome in children. It is highly steroid-responsive; over 90% achieve complete remission with corticosteroids. Cyclophosphamide and mycophenolate are used in frequently relapsing or steroid-dependent disease. Rituximab is reserved for difficult-to-treat steroid-dependent cases.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.