Minimal change disease
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| Minimal change disease Classification and external resources | |
| ICD-10 | N04. |
|---|---|
| ICD-9 | 581.3 |
| DiseasesDB | 8230 |
| MedlinePlus | 000496 |
| eMedicine | med/1483 |
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Overview
Minimal change disease or nil disease (lipoid nephrosis) is a disease of the kidney which causes nephrotic syndrome and usually affects children (peak incidence at 2-3 years of age).[1]
Symptoms
The symptoms are proteinuria (leakage of protein into the urine) and water retention. There are other kidney diseases that have these same symptoms but a needle biopsy shows change in the kidney tissue if these other diseases are present.
Causes
Minimal change disease can be associated with food allergies, medications, or hematologic malignancies, or it can occur idiopathically. The pathology does not appear to involve complement, immunoglobulins, or immune complex deposition. Rather, an altered cell-mediated immunologic response with abnormal secretion of lymphokines by T cells is thought to reduce the production of anions in the glomerular basement membrane, thereby increasing the glomerular permeability to serum albumin through a reduction of electrostatic repulsion.[2] The loss of anionic charges is also thought to favor foot process fusion. With minimal change disease the kidney tissue appears normal under a light microscope, but shows podocyte foot process effacement under an electron microscope.[1]
Treatment
Prednisone is prescribed along with a blood pressure medication, typically an ACE inhibitor such as lisinopril. Often the liver is overactive with minimal change disease and over produces cholesterol. Therefore a statin drug is often prescribed for the duration of the treatment. When the urine is clear of protein, the drugs can be discontinued. 50% of patients will relapse and need further treatment.
Other notes
80% of those who get minimal change disease have a recurrence with 20% never realizing another occurrence. Some authors have noted that other conditions associated with T-cell abnormalities, such as Hodgkin's disease and T-cell lymphoma, are sometimes associated with minimal change disease.
External links
- Kidcomm - An online resource for parents dealing with childhood kidney diseases
- National Kidney Foundation
References
- ↑ 1.0 1.1 Kumar V, Fausto N, Abbas A (editors) (2003). Robbins & Cotran Pathologic Basis of Disease, 7th, Saunders, pp. 981-2. ISBN 978-0-721-60187-8.
- ↑ Mathieson P (2003). "Immune dysregulation in minimal change nephropathy". Nephrol Dial Transplant 18 Suppl 6: vi26-9. PMID 12953038.
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
