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.

Physical Examination

• Physical examination of patients with minimal change disease is usually remarkable for: facial, scrotal , vulvar edema , ascites and pleural effusions.

Appearance of the Patient

• Patients with minimal change disease usually appear swollen (especially around the eyes, feet, and ankles, and in the abdomen).
• 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).

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.
• Onset is frequently preceded by upper respiratory tract infection.

Heart

• Pericardial effusion.

Abdomen

•  Anasarca may develop along with ascites.

Back

• Back examination of patients with minimal change disease is usually normal.

Genitourinary

• Edema of the scrotum or labia.

Neuromuscular

• Neuromuscular examination of patients with minimal change disease is usually normal.

Extremities

• Subungual edema.
• Muehrcke lines of the toe and fingernails.