A 5 year old child presented with periorbital swelling and oliguria. Nephrotic syndrome is suspected. Which of the following is the commonest type of nephrotic syndrome in this child?: (A) Minimal change disease, (B) Chronic glomerulonephritis, (C) Hemolytic uremic syndrome, (D) Congenital nephrotic syndrome
Answer is A. Minimal change disease (MCD), sometimes known as nil lesion, causes 70-90% of nephrotic syndrome in childhood but only 10-15% of nephrotic syndrome in adults. Affected patients are generally younger than age 6 years at onset. Typically, periorbital swelling and oliguria are noted, often following an influenza-like syndrome. Minimal change disease on renal biopsy shows no obvious glomerular lesion by light microscopy and is negative for deposits by immunofluorescent microscopy. Ref: Lewis J.B., Neilson E.G. (2012). Chapter 283. Glomerular Diseases. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.