Minimal change disease history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Clinical Features

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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.[1] Children are less likely to present with other clinical features, such as hypertension, renal failure, or hematuria.[1][2]

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, infections, such as pneumonia in an otherwise healthy individual, may be the first sign of nephrotic syndrome in minimal change disease.[1]

Other non-specific symptoms may include irritability, headache, and depression.[2]

Symptoms due to complications of nephrotic syndrome are also described, such as symptoms of thromboembolic events, cardiovascular disease, thyroid dysfunction, hypocalcemia and hypovitaminosis D.[2]

References

  1. 1.0 1.1 1.2 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.
  2. 2.0 2.1 2.2 Saha TC, Singh H (2006). "Minimal change disease: a review". South Med J. 99 (11): 1264–70. PMID 17195422.

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