Minimal change disease physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S[2]

Overview

Common physical examination findings of minimal change disease include facial, scrotal and vulvar edema. Finger abnormalities, ascites and pleural effusions due to edema may also be present.Edema may be preceded by an upper respiratory tract infection.On physical examination, symptoms of nephrotic syndrome are most commonly noted. Inspection may include . Additionally, subungual edema may be noted showing a paradoxically pink lunulae and white nail beds. Finger abnormalities also include Muehrcke's lines of the toe and fingernails, which are horizontal white lines. Finally, ascites and pleural effusions due to edema may also be present.[1]

Physical Examination

Appearance of the Patient

  • Patients with minimal change disease usually appear swollen (especially around the eyes, feet, and ankles, and in the abdomen).[3]
  • Weight gain (from fluid retention).
  • Subungual edema with horizontal lines which are called Muehrcke lines may also seen in some patients.

Vital Signs

  • The blood pressure is usually normal in children, but may be elevated in adults.

HEENT

Neck

Lungs

  • Pleural effusion.
  • Pneumonia due to Ig depletion and altered T cell function.[5]
  • Onset is frequently preceded by upper respiratory tract infection.[6]

Heart

  • Pericardial effusion.[7]

Abdomen

  •  Anasarca may develop along with ascites.[8][9]

Back

Genitourinary

Neuromuscular

Extremities

References

  1. 1.0 1.1 Saha TC, Singh H (2006). [http 17195422://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17195422 "Minimal change disease: a review"] Check |url= value (help). South Med J. 99 (11): 1264–70. PMID 17195422.
  2. Saha TC, Singh H (2006). [http 17195422://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17195422 "Minimal change disease: a review"] Check |url= value (help). South Med J. 99 (11): 1264–70. PMID 17195422.
  3. Vivarelli M, Massella L, Ruggiero B, Emma F (February 2017). "Minimal Change Disease". Clin J Am Soc Nephrol. 12 (2): 332–345. doi:10.2215/CJN.05000516. PMC 5293332. PMID 27940460.
  4. Vivarelli, Marina; Massella, Laura; Ruggiero, Barbara; Emma, Francesco (2017). "Minimal Change Disease". Clinical Journal of the American Society of Nephrology. 12 (2): 332–345. doi:10.2215/CJN.05000516. ISSN 1555-9041.
  5. Shalhoub RJ (September 1974). "Pathogenesis of lipoid nephrosis: a disorder of T-cell function". Lancet. 2 (7880): 556–60. PMID 4140273.
  6. Vivarelli M, Massella L, Ruggiero B, Emma F (February 2017). "Minimal Change Disease". Clin J Am Soc Nephrol. 12 (2): 332–345. doi:10.2215/CJN.05000516. PMC 5293332. PMID 27940460.
  7. Vivarelli, Marina; Massella, Laura; Ruggiero, Barbara; Emma, Francesco (2017). "Minimal Change Disease". Clinical Journal of the American Society of Nephrology. 12 (2): 332–345. doi:10.2215/CJN.05000516. ISSN 1555-9041.
  8. Vivarelli, Marina; Massella, Laura; Ruggiero, Barbara; Emma, Francesco (2017). "Minimal Change Disease". Clinical Journal of the American Society of Nephrology. 12 (2): 332–345. doi:10.2215/CJN.05000516. ISSN 1555-9041.
  9. Vivarelli M, Massella L, Ruggiero B, Emma F (February 2017). "Minimal Change Disease". Clin J Am Soc Nephrol. 12 (2): 332–345. doi:10.2215/CJN.05000516. PMC 5293332. PMID 27940460.
  10. Vivarelli, Marina; Massella, Laura; Ruggiero, Barbara; Emma, Francesco (2017). "Minimal Change Disease". Clinical Journal of the American Society of Nephrology. 12 (2): 332–345. doi:10.2215/CJN.05000516. ISSN 1555-9041.
  11. Vivarelli M, Massella L, Ruggiero B, Emma F (February 2017). "Minimal Change Disease". Clin J Am Soc Nephrol. 12 (2): 332–345. doi:10.2215/CJN.05000516. PMC 5293332. PMID 27940460.
  12. Vivarelli, Marina; Massella, Laura; Ruggiero, Barbara; Emma, Francesco (2017). "Minimal Change Disease". Clinical Journal of the American Society of Nephrology. 12 (2): 332–345. doi:10.2215/CJN.05000516. ISSN 1555-9041.

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