Minimal change disease laboratory findings: Difference between revisions

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__NOTOC__
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{{Minimal change disease}}
{{Minimal change disease}}
{{CMG}}; {{AE}} [[User:YazanDaaboul|Yazan Daaboul]], [[User:Sergekorjian|Serge Korjian]]
{{CMG}}; {{AE}} {{VKG}}


==Overview==
==Overview==
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==Laboratory Findings==
==Laboratory Findings==
===Blood===
===Blood===
*Elevated [[hematocrit]] due to volume contraction
* [[Fibrinogen]], factors V and VIII, and [[protein C]] increases and increased risk of thrombosis due to  hypercoagulability.<ref name="pmid279404604">{{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="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>
*Serum electrolytes may show pesudohyponatremia, defined as low serum sodium levels due to elevated serum lipids
*[[Hypocalcemia]]
*Hypovitaminosis D
*Normal/elevated serum [[creatinine]]
*[[Hypoalbuminemia]]
*Abnormal lipid profile (total [[cholesterol]], [[LDL-C]], [[HDL-C]], [[triglyceride]]s)
*[[ANA]] panel is usually normal
*[[Complement]] levels are usually normal


*Elevated [[hematocrit]] due to volume contraction.<ref name="pmid279404605">{{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>
*Serum electrolytes may show [[pseudohyponatremia]], defined as low serum sodium levels due to elevated serum lipids.
*[[Hypocalcemia]].
*Hypovitaminosis D.
*Normal/elevated serum [[creatinine]].
*[[Hypoalbuminemia]].
*Abnormal [[lipid profile]] (total [[cholesterol]], [[LDL-C]], [[HDL-C]], [[triglyceride]]s) due to<ref name="pmid279404606">{{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>
**Decreased activity of [[lipoprotein lipase]].
**Decreased [[LDL]] receptor activity.
**Increased urinary loss of [[HDL]] and [[antithrombin III]].
*[[IgG]] decreased.
*[[IgA]] is minimally reduced.<ref name="pmid24527245">{{cite journal |vauthors=Oberweis BS, Mattoo A, Wu M, Goldfarb DS |title=Minimal change disease and IgA deposition: separate entities or common pathophysiology? |journal=Case Rep Nephrol |volume=2013 |issue= |pages=268401 |date=2013 |pmid=24527245 |pmc=3914242 |doi=10.1155/2013/268401 |url=}}</ref>
*[[IgM]] is increased.
===Urine===
===Urine===
24-hour urinary analysis is indicated in the work-up of minimal change disease.                 
* 24-hour urinary analysis is indicated in the work-up of [[minimal change disease]].<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><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>                
*Elevated [[urinary specific gravity]]
 
*[[Proteinuria]] that might reach [[nephrotic]] range
*Elevated [[urinary specific gravity]].
*High urinary protein-[[creatinine]] ratio
*[[Proteinuria]] that might reach [[nephrotic]] range.
*Microscopic [[hematuria]]
*High urinary protein-[[creatinine]] ratio.
*Lipid-laden cells
*Microscopic [[hematuria]].
*Lipid-laden cells.
*Gross [[hematuria]].<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>
*Urinary dipstick showing 3+/4+ [[proteinuria]] (≥300 mg/dl).<ref name="pmid279404603">{{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>
*Urine protein-to-[[creatinine]] ratio >200 mg/mmol.
*Urine [[Protein|proteins]] >3.5 g/d in adults.<ref name="pmid17699450">{{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>
*Increased ''α''2-[[globulin]] and a reduced ''γ''-[[globulin]] fraction.


==References==
==References==

Latest revision as of 14:39, 13 June 2018

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

Overview

Laboratory findings in minimal change disease include elevated hematocrit, pseudohyponatremia, hypocalcemia, and abnormal lipid panel. Findings of urine analysis include elevated urinary specific gravity, proteinuria that might reach nephrotic range, high urinary protein-creatinine ratio, microscopic hematuria, and lipid-laden cells.

Laboratory Findings

Blood

Urine

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. ↑ 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.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ Oberweis BS, Mattoo A, Wu M, Goldfarb DS (2013). "Minimal change disease and IgA deposition: separate entities or common pathophysiology?". Case Rep Nephrol. 2013: 268401. doi:10.1155/2013/268401. PMC 3914242. PMID 24527245.
  6. ↑ 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.
  7. ↑ 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.
  8. ↑ 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.
  9. ↑ 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.
  10. ↑ 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.

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