Minimal change disease history and symptoms: Difference between revisions

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{{Minimal change disease}}
{{Minimal change disease}}
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==Overview==
==Overview==
==Clinical Features==
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.
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.<ref name="pmid17699450">{{cite journal| author=Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G et al.| title=Adult minimal-change disease: clinical characteristics, treatment, and outcomes. | journal=Clin J Am Soc Nephrol | year= 2007 | volume= 2 | issue= 3 | pages= 445-53 | pmid=17699450 | doi=10.2215/CJN.03531006 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17699450  }} </ref> Children are less likely to present with other clinical features, such as hypertension, renal failure, or hematuria.<ref name="pmid17699450">{{cite journal| author=Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G et al.| title=Adult minimal-change disease: clinical characteristics, treatment, and outcomes. | journal=Clin J Am Soc Nephrol | year= 2007 | volume= 2 | issue= 3 | pages= 445-53 | pmid=17699450 | doi=10.2215/CJN.03531006 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17699450  }} </ref><ref name="pmid17195422">{{cite journal| author=Saha TC, Singh H| title=Minimal change disease: a review. | journal=South Med J | year= 2006 | volume= 99 | issue= 11 | pages= 1264-70 | pmid=17195422 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17195422  }} </ref>
 
==History and Symptoms==
The hallmark of  minimal change disease is  [[proteinuria]].<ref name="pmid27940460">{{cite journal |vauthors=Vivarelli M, Massella L, Ruggiero B, Emma F |title=Minimal Change Disease |journal=Clin J Am Soc Nephrol |volume=12 |issue=2 |pages=332–345 |date=February 2017 |pmid=27940460 |pmc=5293332 |doi=10.2215/CJN.05000516 |url=}}</ref>


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.<ref name="pmid17699450">{{cite journal| author=Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G et al.| title=Adult minimal-change disease: clinical characteristics, treatment, and outcomes. | journal=Clin J Am Soc Nephrol | year= 2007 | volume= 2 | issue= 3 | pages= 445-53 | pmid=17699450 | doi=10.2215/CJN.03531006 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17699450  }} </ref>
=== History ===
Patients with minimal change disease may have a positive history of:<ref name="VivarelliMassella2017">{{cite journal|last1=Vivarelli|first1=Marina|last2=Massella|first2=Laura|last3=Ruggiero|first3=Barbara|last4=Emma|first4=Francesco|title=Minimal Change Disease|journal=Clinical Journal of the American Society of Nephrology|volume=12|issue=2|year=2017|pages=332–345|issn=1555-9041|doi=10.2215/CJN.05000516}}</ref><ref name="pmid176994502">{{cite journal |vauthors=Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G, D'Agati V, Appel G |title=Adult minimal-change disease: clinical characteristics, treatment, and outcomes |journal=Clin J Am Soc Nephrol |volume=2 |issue=3 |pages=445–53 |date=May 2007 |pmid=17699450 |doi=10.2215/CJN.03531006 |url=}}</ref><ref name="pmid26450933">{{cite journal |vauthors=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 |title=AKI in Children Hospitalized with Nephrotic Syndrome |journal=Clin J Am Soc Nephrol |volume=10 |issue=12 |pages=2110–8 |date=December 2015 |pmid=26450933 |pmc=4670770 |doi=10.2215/CJN.06620615 |url=}}</ref>
* [[Upper respiratory tract]] infection.
* [[Infections]] such as
** [[Sepsis]]
** [[Pneumonia]]
** [[Peritonitis]]
* [[Diarrhea]]


Other non-specific symptoms may include irritability, headache, and depression.<ref name="pmid17195422">{{cite journal| author=Saha TC, Singh H| title=Minimal change disease: a review. | journal=South Med J | year= 2006 | volume= 99 | issue= 11 | pages= 1264-70 | pmid=17195422 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17195422  }} </ref>
=== Common Symptoms ===
Common symptoms of minimal change disease include:<ref name="pmid279404602">{{cite journal |vauthors=Vivarelli M, Massella L, Ruggiero B, Emma F |title=Minimal Change Disease |journal=Clin J Am Soc Nephrol |volume=12 |issue=2 |pages=332–345 |date=February 2017 |pmid=27940460 |pmc=5293332 |doi=10.2215/CJN.05000516 |url=}}</ref><ref name="VivarelliMassella20173">{{cite journal|last1=Vivarelli|first1=Marina|last2=Massella|first2=Laura|last3=Ruggiero|first3=Barbara|last4=Emma|first4=Francesco|title=Minimal Change Disease|journal=Clinical Journal of the American Society of Nephrology|volume=12|issue=2|year=2017|pages=332–345|issn=1555-9041|doi=10.2215/CJN.05000516}}</ref><ref name="pmid176994503">{{cite journal |vauthors=Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G, D'Agati V, Appel G |title=Adult minimal-change disease: clinical characteristics, treatment, and outcomes |journal=Clin J Am Soc Nephrol |volume=2 |issue=3 |pages=445–53 |date=May 2007 |pmid=17699450 |doi=10.2215/CJN.03531006 |url=}}</ref><ref name="pmid264509332">{{cite journal |vauthors=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 |title=AKI in Children Hospitalized with Nephrotic Syndrome |journal=Clin J Am Soc Nephrol |volume=10 |issue=12 |pages=2110–8 |date=December 2015 |pmid=26450933 |pmc=4670770 |doi=10.2215/CJN.06620615 |url=}}</ref>
* [[Fatigue]]
* [[Edema]]: [[periorbital edema]], [[weight gain]]<ref name="pmid17699450">{{cite journal| author=Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G et al.| title=Adult minimal-change disease: clinical characteristics, treatment, and outcomes. | journal=Clin J Am Soc Nephrol | year= 2007 | volume= 2 | issue= 3 | pages= 445-53 | pmid=17699450 | doi=10.2215/CJN.03531006 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17699450  }} </ref>
* [[Hypertension]]
* [[Hematuria]]<ref name="pmid17699450">{{cite journal| author=Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G et al.| title=Adult minimal-change disease: clinical characteristics, treatment, and outcomes. | journal=Clin J Am Soc Nephrol | year= 2007 | volume= 2 | issue= 3 | pages= 445-53 | pmid=17699450 | doi=10.2215/CJN.03531006 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17699450  }} </ref><ref name="pmid17195422">{{cite journal| author=Saha TC, Singh H| title=Minimal change disease: a review. | journal=South Med J | year= 2006 | volume= 99 | issue= 11 | pages= 1264-70 | pmid=17195422 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17195422  }} </ref>
* Symptoms of [[infections]], such as [[pneumonia]]<ref name="pmid17699450">{{cite journal| author=Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G et al.| title=Adult minimal-change disease: clinical characteristics, treatment, and outcomes. | journal=Clin J Am Soc Nephrol | year= 2007 | volume= 2 | issue= 3 | pages= 445-53 | pmid=17699450 | doi=10.2215/CJN.03531006 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17699450  }} </ref>
* [[Irritability]]
* [[Headache]]


Symptoms due to complications of nephrotic syndrome are also described, such as symptoms of thromboembolic events, cardiovascular disease, thyroid dysfunction, hypocalcemia and hypovitaminosis D.<ref name="pmid17195422">{{cite journal| author=Saha TC, Singh H| title=Minimal change disease: a review. | journal=South Med J | year= 2006 | volume= 99 | issue= 11 | pages= 1264-70 | pmid=17195422 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17195422  }} </ref>
=== Less Common Symptoms ===
Less common symptoms of minimal change disease include<ref name="VivarelliMassella20172">{{cite journal|last1=Vivarelli|first1=Marina|last2=Massella|first2=Laura|last3=Ruggiero|first3=Barbara|last4=Emma|first4=Francesco|title=Minimal Change Disease|journal=Clinical Journal of the American Society of Nephrology|volume=12|issue=2|year=2017|pages=332–345|issn=1555-9041|doi=10.2215/CJN.05000516}}</ref><ref name="pmid176994504">{{cite journal |vauthors=Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G, D'Agati V, Appel G |title=Adult minimal-change disease: clinical characteristics, treatment, and outcomes |journal=Clin J Am Soc Nephrol |volume=2 |issue=3 |pages=445–53 |date=May 2007 |pmid=17699450 |doi=10.2215/CJN.03531006 |url=}}</ref><ref name="pmid264509333">{{cite journal |vauthors=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 |title=AKI in Children Hospitalized with Nephrotic Syndrome |journal=Clin J Am Soc Nephrol |volume=10 |issue=12 |pages=2110–8 |date=December 2015 |pmid=26450933 |pmc=4670770 |doi=10.2215/CJN.06620615 |url=}}</ref>
* [[Thromboembolism]]<ref name="pmid22344511">{{cite journal |vauthors=Kerlin BA, Ayoob R, Smoyer WE |title=Epidemiology and pathophysiology of nephrotic syndrome-associated thromboembolic disease |journal=Clin J Am Soc Nephrol |volume=7 |issue=3 |pages=513–20 |date=March 2012 |pmid=22344511 |pmc=3302669 |doi=10.2215/CJN.10131011 |url=}}</ref>
* [[Cardiovascular disease]]
* [[Thyroid]] dysfunction
* [[Hypocalcemia]]
* Hypovitaminosis D<ref name="pmid17195422">{{cite journal| author=Saha TC, Singh H| title=Minimal change disease: a review. | journal=South Med J | year= 2006 | volume= 99 | issue= 11 | pages= 1264-70 | pmid=17195422 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17195422  }} </ref>


==References==
==References==
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[[Category:Needs content]]
[[Category:Nephrology]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Kidney diseases]]
[[Category:Kidney diseases]]
[[Category:Urology]]
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Latest revision as of 14:33, 13 June 2018

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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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