Minimal-Change Glomerulonephritis

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(Lipoid nephrosis; “nil disease”)

The minimal change disease causes – mostly in children – the abrupt onset of edema and severe proteinuria. Typically, the kidney function remains normal. Diagnosis is based on clinical criteria or kidney biopsy. The prognosis is excellent. The therapy consists of the administration of corticosteroids or non-responders with the administration of cyclophosphamide or cyclosporin.

The minimal change disease (MCGN) is the most common cause of nephrotic syndrome in children aged 4-8 years (80-90% of nephrotic syndrome in children), but it also occurs in adults (10-20% of the adult nephrotic syndrome). The cause is almost always unknown, although rare cases by drugs (especially by NSAIDs) and hematologic cancers (particularly Hodgkin lymphoma) may be caused.

The minimal change disease causes – mostly in children – the abrupt onset of edema and severe proteinuria. Typically, the kidney function remains normal. Diagnosis is based on clinical criteria or kidney biopsy. The prognosis is excellent. The therapy consists of the administration of corticosteroids or non-responders with the administration of cyclophosphamide or cyclosporin. The minimal change disease (MCGN) is the most common cause of nephrotic syndrome in children aged 4-8 years (80-90% of nephrotic syndrome in children), but it also occurs in adults (10-20% of the adult nephrotic syndrome). The cause is almost always unknown, although rare cases by drugs (especially by NSAIDs) and hematologic cancers (particularly Hodgkin lymphoma) may be caused. Symptoms and complaints The MCGN usually causes nephrotic syndrome without hypertension or azotemia. In 20% of patients there is a microscopic hematuria. Azotemia can> 60 years occur in secondary forms and patients. In patients with MCGN albumin is lost in larger quantities than the larger serum proteins, probably because the MCGN changes in the charge-dependent filtration function causes that selectively affects the albumin. Diagnosis In adults with idiopathic nephrotic syndrome, rare renal biopsy in children include: Sudden onset of an unexplained proteinuria in the nephrotic range, mainly albumin normal renal function Nichtnephritisches urine sediment kidney biopsy in atypical cases, a kidney biopsy is required when atypical cases and in adults. In electron microscopy is an edema is swelling with diffuse (broadening, fusing) of the leg extensions (podocytes) of the epithelial cells (Electron microscopic indicator in immunological glomerular diseases.). Complement and Ig deposits are absent in immunofluorescence. Although the fusion of podocytes is not observed in the absence of proteinuria, despite normal podocytes a heavy Proteinämie may be. Minimal change disease imaging provided by Agnes Fogo, M.D., and the American Journal of Kidney Disease, Atlas of Renal Pathology (see www.ajkd.org). var model = {thumbnailUrl: ‘/-/media/manual/professional/images/minimal_change_disease_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/-/media/manual/professional/images/minimal_change_disease_high_de.jpg?la = en & thn = 0 ‘, title:’ minimal change disease ‘, description:’ u003Ca id = “v38396940 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eIn this transmission electron micrograph is a diffuse fusion of foot processes to see ( u003cspan class = “” symbol “” u003e x u003c / span u003e800). u003c / p u003e u003c / div u003e ‘credits’ figure provided by Agnes Fogo

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