A child develops nephrotic syndrome 2 weeks after a bee sting. Renal biopsy shows no light microscopy abnormality but electron microscopy reveals diffuse podocyte foot process effacement. The most likely diagnosis is:

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

Explanation

Minimal change disease (MCD, nil disease) shows no abnormality on light microscopy or immunofluorescence, with the only ultrastructural finding being diffuse podocyte foot process effacement on EM. It is the commonest cause of nephrotic syndrome in children, responds dramatically to steroids, and is associated with allergic triggers (bee sting, NSAIDs) in some 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.