A 4-year-old girl presents with swelling of the legs and ankles. Physical examination reveals pitting edema of the lower extremities. Urinalysis show 2+ proteinuria. The urinary sediment contains no inflammatory cells or red blood cells. Serum levels of BUN and creatinine are normal. The patient recovers completely after a course of corticosteroids. Which of the following pathologic findings might be expected in the urine prior to treatment with corticosteroids?

The loss of protein in the urine in patients with nephrotic syndrome leads to hypoalbuminemia. A compensatory increase in lipoprotein secretion by the liver results in hyperlipidemia, which is reflected in the presence of lipid droplets in the urine. For this reason, minimal change disease is also referred to as lipoid nephrosis. Eosinophils (choice B) may be observed in allergic nephritis. White blood cell casts (choice E) are features of pyelonephritis.Diagnosis: Minimal change nephrotic syndrome