Minimal Change Disease After Elective Surgical Abortion: A Case Report

Area of Science:

• Nephrology
• Obstetrics & Gynecology

Background:

• Physiological changes in pregnancy increase renal blood flow and glomerular filtration rate, leading to transient proteinuria.
• Nephrotic range proteinuria (>3 g/d) in late pregnancy is commonly caused by preeclampsia.
• Minimal change disease (MCD) is a rare cause of nephrotic syndrome during pregnancy and even rarer postpartum.

Observation:

• A 21-year-old woman presented with symptoms of nephrotic syndrome 3 weeks after an elective surgical abortion.
• Investigations revealed nephrotic range proteinuria, hypoalbuminemia, and dyslipidemia, with normal serum creatinine and negative autoimmune serology.
• Renal biopsy confirmed Minimal Change Disease (MCD) with podocyte effacement and normal glomerular structure.

Findings:

• The patient received treatment with steroids, diuretics, statins, and angiotensin receptor blockers.
• She showed significant improvement with resolution of symptoms and laboratory abnormalities.
• This is the first reported case of MCD without acute renal failure after elective pregnancy termination.

Implications:

• This case expands the understanding of rare postpartum renal complications.
• It highlights the importance of considering MCD in women presenting with nephrotic syndrome after abortion.
• Early diagnosis and treatment can lead to favorable outcomes in these rare cases.