Minimal change disease physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Common physical examination findings of minimal change disease include facial, scrotal and vulvar [[edema]]. Finger abnormalities, [[ascites]] and [[pleural effusion]]s 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 | Common physical examination findings of minimal change disease include facial, scrotal and vulvar [[edema]]. Finger abnormalities, [[ascites]] and [[pleural effusion]]s 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 effusion]]s due to edema may also be present.<ref name="pmid17195422">{{cite journal| author=Saha TC, Singh H| title=Minimal change disease: a review. | journal=South Med J | year= 2006 | volume= 99 | issue= 11 | pages= 1264-70 | pmid=17195422 | doi= | pmc= | url=http 17195422://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17195422 }} </ref> | ||
==Physical Examination== | ==Physical Examination== | ||
* Physical examination of patients with [[minimal change disease]] is usually remarkable for:[[facial]], scrotal , [[Vulva|vulvar]] [[edema]] [[Ascites|, ascites]] and [[pleural effusion]]s.<ref name="pmid171954222">{{cite journal| author=Saha TC, Singh H| title=Minimal change disease: a review. | journal=South Med J | year= 2006 | volume= 99 | issue= 11 | pages= 1264-70 | pmid=17195422 | doi= | pmc= | url=http 17195422://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17195422 }}</ref> | * Physical examination of patients with [[minimal change disease]] is usually remarkable for: [[facial]], scrotal , [[Vulva|vulvar]] [[edema]] [[Ascites|, ascites]] and [[pleural effusion]]s.<ref name="pmid171954222">{{cite journal| author=Saha TC, Singh H| title=Minimal change disease: a review. | journal=South Med J | year= 2006 | volume= 99 | issue= 11 | pages= 1264-70 | pmid=17195422 | doi= | pmc= | url=http 17195422://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17195422 }}</ref> | ||
=== Appearance of the Patient === | === Appearance of the Patient === | ||
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=== Back === | === Back === | ||
* Back examination of patients with [disease | * Back examination of patients with [[minimal change disease]] is usually normal. | ||
=== Genitourinary === | === Genitourinary === | ||
* Edema of the scrotum or labia.<ref name="VivarelliMassella20174">{{cite journal|last1=Vivarelli|first1=Marina|last2=Massella|first2=Laura|last3=Ruggiero|first3=Barbara|last4=Emma|first4=Francesco|title=Minimal Change Disease|journal=Clinical Journal of the American Society of Nephrology|volume=12|issue=2|year=2017|pages=332–345|issn=1555-9041|doi=10.2215/CJN.05000516}}</ref> | * Edema of the scrotum or labia.<ref name="VivarelliMassella20174">{{cite journal|last1=Vivarelli|first1=Marina|last2=Massella|first2=Laura|last3=Ruggiero|first3=Barbara|last4=Emma|first4=Francesco|title=Minimal Change Disease|journal=Clinical Journal of the American Society of Nephrology|volume=12|issue=2|year=2017|pages=332–345|issn=1555-9041|doi=10.2215/CJN.05000516}}</ref><ref name="pmid279404604">{{cite journal |vauthors=Vivarelli M, Massella L, Ruggiero B, Emma F |title=Minimal Change Disease |journal=Clin J Am Soc Nephrol |volume=12 |issue=2 |pages=332–345 |date=February 2017 |pmid=27940460 |pmc=5293332 |doi=10.2215/CJN.05000516 |url=}}</ref> | ||
=== Neuromuscular === | |||
* Neuromuscular examination of patients with [[minimal change disease]] is usually normal. | |||
=== Extremities === | |||
* Subungual edema.<ref name="pmid17195422" /> | |||
* [[Muehrcke line]]s of the toe and fingernails.<ref name="VivarelliMassella20175">{{cite journal|last1=Vivarelli|first1=Marina|last2=Massella|first2=Laura|last3=Ruggiero|first3=Barbara|last4=Emma|first4=Francesco|title=Minimal Change Disease|journal=Clinical Journal of the American Society of Nephrology|volume=12|issue=2|year=2017|pages=332–345|issn=1555-9041|doi=10.2215/CJN.05000516}}</ref> | |||
==References== | ==References== | ||
Latest revision as of 14:38, 13 June 2018
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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
- Physical examination of patients with minimal change disease is usually remarkable for: facial, scrotal , vulvar edema , ascites and pleural effusions.[2]
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
- HEENT examination of patients with minimal change disease is usually shows facial edema(periorbital).[4]
Neck
- Neck examination of patients with minimal change disease is usually normal.
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
Back
- Back examination of patients with minimal change disease is usually normal.
Genitourinary
Neuromuscular
- Neuromuscular examination of patients with minimal change disease is usually normal.
Extremities
- Subungual edema.[1]
- Muehrcke lines of the toe and fingernails.[12]
References
- ↑ 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. - ↑ 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. - ↑ 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.
- ↑ 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.
- ↑ Shalhoub RJ (September 1974). "Pathogenesis of lipoid nephrosis: a disorder of T-cell function". Lancet. 2 (7880): 556–60. PMID 4140273.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.