Minimal change disease history and symptoms

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

Overview

The hallmark of minimal change disease in children is acute-onset proteinuria that progresses into nephrotic syndrome. Fatigue and subsequent edema develops with symptoms of periorbital edema and weight gain. Children are less likely to present with other clinical features, such as hypertension, renal failure, or hematuria. In contrast, adults are more likely to present with hypertension in approximately 40% of cases, and hematuria in approximately 30% of cases. A reduced estimated glomerular filtration rate (eGFR) at presentation is also not uncommon. Finally, upper respiratory tract infection, such as pneumonia in an otherwise healthy individual, may be the first sign of nephrotic syndrome in minimal change disease.

History and Symptoms

The hallmark of minimal change disease is proteinuria.[1]

History

Patients with minimal change disease may have a positive history of:[2][3][4]

Common Symptoms

Common symptoms of minimal change disease include:[5][6][7][8]

Less Common Symptoms

Less common symptoms of minimal change disease include[11][12][13]

References

  1. 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.
  2. 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.
  3. Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G, D'Agati V, Appel G (May 2007). "Adult minimal-change disease: clinical characteristics, treatment, and outcomes". Clin J Am Soc Nephrol. 2 (3): 445–53. doi:10.2215/CJN.03531006. PMID 17699450.
  4. Rheault MN, Zhang L, Selewski DT, Kallash M, Tran CL, Seamon M, Katsoufis C, Ashoor I, Hernandez J, Supe-Markovina K, D'Alessandri-Silva C, DeJesus-Gonzalez N, Vasylyeva TL, Formeck C, Woll C, Gbadegesin R, Geier P, Devarajan P, Carpenter SL, Kerlin BA, Smoyer WE (December 2015). "AKI in Children Hospitalized with Nephrotic Syndrome". Clin J Am Soc Nephrol. 10 (12): 2110–8. doi:10.2215/CJN.06620615. PMC 4670770. PMID 26450933.
  5. 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.
  6. 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.
  7. Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G, D'Agati V, Appel G (May 2007). "Adult minimal-change disease: clinical characteristics, treatment, and outcomes". Clin J Am Soc Nephrol. 2 (3): 445–53. doi:10.2215/CJN.03531006. PMID 17699450.
  8. Rheault MN, Zhang L, Selewski DT, Kallash M, Tran CL, Seamon M, Katsoufis C, Ashoor I, Hernandez J, Supe-Markovina K, D'Alessandri-Silva C, DeJesus-Gonzalez N, Vasylyeva TL, Formeck C, Woll C, Gbadegesin R, Geier P, Devarajan P, Carpenter SL, Kerlin BA, Smoyer WE (December 2015). "AKI in Children Hospitalized with Nephrotic Syndrome". Clin J Am Soc Nephrol. 10 (12): 2110–8. doi:10.2215/CJN.06620615. PMC 4670770. PMID 26450933.
  9. 9.0 9.1 9.2 Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G; et al. (2007). "Adult minimal-change disease: clinical characteristics, treatment, and outcomes". Clin J Am Soc Nephrol. 2 (3): 445–53. doi:10.2215/CJN.03531006. PMID 17699450.
  10. 10.0 10.1 Saha TC, Singh H (2006). "Minimal change disease: a review". South Med J. 99 (11): 1264–70. PMID 17195422.
  11. 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.
  12. Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G, D'Agati V, Appel G (May 2007). "Adult minimal-change disease: clinical characteristics, treatment, and outcomes". Clin J Am Soc Nephrol. 2 (3): 445–53. doi:10.2215/CJN.03531006. PMID 17699450.
  13. Rheault MN, Zhang L, Selewski DT, Kallash M, Tran CL, Seamon M, Katsoufis C, Ashoor I, Hernandez J, Supe-Markovina K, D'Alessandri-Silva C, DeJesus-Gonzalez N, Vasylyeva TL, Formeck C, Woll C, Gbadegesin R, Geier P, Devarajan P, Carpenter SL, Kerlin BA, Smoyer WE (December 2015). "AKI in Children Hospitalized with Nephrotic Syndrome". Clin J Am Soc Nephrol. 10 (12): 2110–8. doi:10.2215/CJN.06620615. PMC 4670770. PMID 26450933.
  14. Kerlin BA, Ayoob R, Smoyer WE (March 2012). "Epidemiology and pathophysiology of nephrotic syndrome-associated thromboembolic disease". Clin J Am Soc Nephrol. 7 (3): 513–20. doi:10.2215/CJN.10131011. PMC 3302669. PMID 22344511.

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