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Minimal Change Disease in an Adult: A Case Report
Shashank Neupane1, Prasamsa Pudasaini1, Anupam Sharma1
1Nepalese Army Institute of Health Sciences, Sanobharyang, Kathmandu, Nepal.
Abstract:
Minimal change disease is an important cause of nephrotic syndrome in children, however, few cases are seen among adults. There is very little literature regarding the occurrence of minimal change disease in adults. We reported a case of a 63-year-old male who presented with the complaint of swelling around the eyes mostly during the morning for 18 days and frothing of urine for 7 days. On examination, the patient was ill-looking and had edema around the eyes and over the ankles. After preliminary investigations, renal biopsy was performed and electron microscopy revealed diffuse effacement of foot processes of visceral epithelial cells suggesting minimal change disease (podocytopathy). The patient has been treated with tablet prednisolone 60 mg per oral once daily, tablet ramipril 2.5 mg per oral once daily, and tablet torsemide 20 mg per oral twice daily. Hence, minimal change disease should also be considered as a differential diagnosis in adults presenting with the features of nephrotic syndrome.
Keywords:
electron microscopy; minimal change disease; nephrotic syndrome; prednisolone.
Insights
Minimal change disease, a cause of nephrotic syndrome, is rare in adults. This case highlights its consideration in adult nephrotic syndrome presentations, confirmed by electron microscopy.
Area of Science:
- Nephrology
- Pathology
Background:
- Minimal change disease is a primary cause of nephrotic syndrome in children.
- Literature on adult minimal change disease is scarce.
Observation:
- A 63-year-old male presented with edema and frothy urine, indicative of nephrotic syndrome.
- Clinical examination revealed periorbital and ankle edema.
Findings:
- Renal biopsy and electron microscopy confirmed diffuse effacement of podocyte foot processes, characteristic of minimal change disease (podocytopathy).
- The patient received treatment with prednisolone, ramipril, and torsemide.
Implications:
- Minimal change disease should be included in the differential diagnosis for adult nephrotic syndrome.
- Early diagnosis and treatment with corticosteroids can improve outcomes in adult cases.
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