Minimal change disease electron microscopy: Difference between revisions
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==Overview== | ==Overview== | ||
A kidney [[biopsy]] is not routinely performed as soon as the nephrotic syndrome is found in lab work-up. According to the National Kidney Foundation (NKF) Kidney Disease – Improve Global Outcomes (KDIGO) guidelines in 2012, an initial attempt using [[corticosteroid]]s should be performed before a [[renal]] [[biopsy]] is performed. [[Electron microscopy]] is required for the diagnosis of minimal change disease. It shows effacement (fusion) of [[podocyte]]s, which are visceral [[epithelial cell]]s, with slit-pore membrane obliteration between [[podocyte]] foot processes. However, [[podocyte]] [[effacement]] is not specific and should not be considered [[pathognomonic]] of the disease. | A kidney [[biopsy]] is not routinely performed as soon as the nephrotic syndrome is found in lab work-up. According to the National Kidney Foundation (NKF) Kidney Disease – Improve Global Outcomes (KDIGO) guidelines in 2012, an initial attempt using [[corticosteroid]]s should be performed before a [[renal]] [[biopsy]] is performed. [[Electron microscopy]] is required for the diagnosis of [[minimal change disease]]. It shows [[effacement]] (fusion) of [[podocyte]]s, which are visceral [[epithelial cell]]s, with slit-pore membrane obliteration between [[podocyte]] foot processes. However, [[podocyte]] [[effacement]] is not specific and should not be considered [[pathognomonic]] of the disease. | ||
== Electron microscopy == | == Electron microscopy == | ||
* [[Effacement]] of foot processes is seen in [[minimal change disease]] on [[Electron microscope|electron microscopy]].<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="pmid23871408">{{cite journal| author=Beck L, Bomback AS, Choi MJ, Holzman LB, Langford C, Mariani LH et al.| title=KDOQI US commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis. | journal=Am J Kidney Dis | year= 2013 | volume= 62 | issue= 3 | pages= 403-41 | pmid=23871408 | doi=10.1053/j.ajkd.2013.06.002 |pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23871408 }} </ref><ref name="pmid12704572">{{cite journal|author=D'Agati V| title=Pathologic classification of focal segmental glomerulosclerosis.|journal=Semin Nephrol | year= 2003 | volume= 23 | issue= 2 | pages= 117-34 | pmid=12704572|doi=10.1053/snep.2003.50012 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12704572 }} </ref> | * [[Effacement]] of foot processes is seen in [[minimal change disease]] on [[Electron microscope|electron microscopy]] and this is the only morphologic feature of [[minimal change disease]] on [[electron microscopy]].<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="pmid23871408">{{cite journal| author=Beck L, Bomback AS, Choi MJ, Holzman LB, Langford C, Mariani LH et al.| title=KDOQI US commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis. | journal=Am J Kidney Dis | year= 2013 | volume= 62 | issue= 3 | pages= 403-41 | pmid=23871408 | doi=10.1053/j.ajkd.2013.06.002 |pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23871408 }} </ref><ref name="pmid12704572">{{cite journal|author=D'Agati V| title=Pathologic classification of focal segmental glomerulosclerosis.|journal=Semin Nephrol | year= 2003 | volume= 23 | issue= 2 | pages= 117-34 | pmid=12704572|doi=10.1053/snep.2003.50012 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12704572 }} </ref> | ||
[[File:Mcd electron microscopy.png|alt=Electron microscopy of minimal change disease |center|thumb|https://commons.wikimedia.org/wiki/File:Minimal_Change_Disease_Pathology_Diagram.svg#/media/File:Minimal_Change_Disease_Pathology_Diagram.svg]] | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Latest revision as of 14:46, 13 June 2018
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Minimal Change Disease Microchapters |
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Treatment |
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Minimal change disease electron microscopy On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, Serge Korjian, Vamsikrishna Gunnam M.B.B.S [2]
Overview
A kidney biopsy is not routinely performed as soon as the nephrotic syndrome is found in lab work-up. According to the National Kidney Foundation (NKF) Kidney Disease – Improve Global Outcomes (KDIGO) guidelines in 2012, an initial attempt using corticosteroids should be performed before a renal biopsy is performed. Electron microscopy is required for the diagnosis of minimal change disease. It shows effacement (fusion) of podocytes, which are visceral epithelial cells, with slit-pore membrane obliteration between podocyte foot processes. However, podocyte effacement is not specific and should not be considered pathognomonic of the disease.
Electron microscopy
- Effacement of foot processes is seen in minimal change disease on electron microscopy and this is the only morphologic feature of minimal change disease on electron microscopy.[1][2][3]
References
- ↑ 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.
- ↑ Beck L, Bomback AS, Choi MJ, Holzman LB, Langford C, Mariani LH; et al. (2013). "KDOQI US commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis". Am J Kidney Dis. 62 (3): 403–41. doi:10.1053/j.ajkd.2013.06.002. PMID 23871408.
- ↑ D'Agati V (2003). "Pathologic classification of focal segmental glomerulosclerosis". Semin Nephrol. 23 (2): 117–34. doi:10.1053/snep.2003.50012. PMID 12704572.