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Medicine General d480f7a6

A child presents with hematuria and nephrotic syndrome. A diagnosis of minimal change disease was made. Which of the following statements about the diagnosis is true:

A
Glomerular function is lost due to loss of polyanions around the foot processes
B
Foot processes of podocytes in the Glomerular membrane are normal
C
Glomerular function is lost due to deposition of IgA on the glomerular membrane
D
Focal segmental changes are observed
High-Yield Explanation
Answer is A (Glomerular function is lost due to loss of polyanions around the foot processes) Loss of polyanionic charge is believed to be the main cause for loss of glomerular function (albuminuria) in minimal change disease Loss of polyanions is believed to result in effacement offoot processes and development of proteinuria in minimal change disease Mechanism of Proteinuria in Minimal change Disease (MCD) (Heptinstall's) Effacement of foot process (Earlier called fusion of foot process) is believed to play an impoant role in causes proteinuria in MCD. The mechanisms responsible for fusion /effacement of foot processes include: Loss of negative charge (Loss of Polyanions) Disruption of components of slit diaphragm (Demonstrated in congenital nephrotic syndrome of the Finnish type) Loss of actin cytoskeleton Detachment of the podocyte from the GBM. Note : Minimal change disease is characterized by diffuse effacement offoot process 'diffuse effacement offoot process is synonymous with fusion offoot processes.

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