Minimal change disease laboratory findings: Difference between revisions
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==Laboratory Findings== | ==Laboratory Findings== | ||
===Blood=== | ===Blood<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>=== | ||
*Elevated [[hematocrit]] due to volume contraction | *Elevated [[hematocrit]] due to volume contraction | ||
*Serum electrolytes may show pesudohyponatremia, defined as low serum sodium levels due to elevated serum lipids | *Serum electrolytes may show pesudohyponatremia, defined as low serum sodium levels due to elevated serum lipids | ||
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*Abnormal lipid profile (total [[cholesterol]], [[LDL-C]], [[HDL-C]], [[triglyceride]]s) | *Abnormal lipid profile (total [[cholesterol]], [[LDL-C]], [[HDL-C]], [[triglyceride]]s) | ||
*[[ANA]] panel is usually normal | *[[ANA]] panel is usually normal | ||
* | *IgG decreased. | ||
*IgA is minimally reduced. | |||
*IgM is increased. | |||
* | |||
===Urine=== | ===Urine=== | ||
* 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> | * 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> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, Serge Korjian
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[1]
- Elevated hematocrit due to volume contraction
- 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, triglycerides)
- ANA panel is usually normal
- IgG decreased.
- IgA is minimally reduced.
- IgM is increased.
Urine
- Elevated urinary specific gravity.
- Proteinuria that might reach nephrotic range.
- High urinary protein-creatinine ratio.
- Microscopic hematuria.
- Lipid-laden cells.
- Gross hematuria.[4]
- Urinary dipstick showing 3+/4+ proteinuria (≥300 mg/dl).[5]
- Urine protein-to-creatinine ratio >200 mg/mmol.
- Urine proteins >3.5 g/d in adults.[6]
- increased α2-globulin and a reduced γ-globulin fraction.
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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.