A 4-year-old child presents with periorbital edema, heavy proteinuria (>3.5 g/day), hypoalbuminemia, and hyperlipidemia. Renal biopsy by light microscopy appears normal, but electron microscopy shows diffuse foot process effacement with no immune deposits. The pathological diagnosis is:

• A Minimal change disease ✓
• B Focal segmental glomerulosclerosis
• C Membranous nephropathy
• D Mesangial IgA nephropathy

Explanation

Minimal change disease (lipoid nephrosis) shows normal light microscopy and no immune deposits on immunofluorescence/EM; the only finding is diffuse podocyte foot process effacement on EM. It is the most common cause of nephrotic syndrome in children and responds dramatically to corticosteroids. FSGS also shows foot process effacement but with segmental sclerosis on LM.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.