genitourinary disorders
Minimal Change Disease
Introduction
Minimal change disease causes abrupt onset of edema and heavy proteinuria, mostly in children. Renal function is typically normal. Diagnosis is based on clinical findings or renal biopsy. Treatment is with corticosteroids or, in patients who do not respond,cyclophosphamideorcyclosporine. Prognosis is excellent. (See also Overview of Nephrotic Syndrome .) Minimal change disease is the most common cause of nephrotic syndrome in children 4 to 8 years (80 to 90% of childhood nephrotic syndrome), but it also occurs in adults (10 to 20% of adult nephrotic syndrome). The cause is almost always unknown, although rare cases may occur secondary to drug use (especially nonsteroidal anti-inflammatory drugs [NSAIDs]) and hematologic cancers (especially Hodgkin Lymphoma ). 