A 4-year-old child was found to be edematous and lethargic. Laboratory findings included evidence of proteinuria and lipiduria, low serum albumin levels, and hyperlipidemia. No abnormalities were found in the urinary sediment
Corticosteroids were given, and the generalized edema disappeared. What is the most likely diagnosis?
A. acute glomerulonephritis
B. membranous nephropathy
C. membranoproliferative glomerulonephritis
D. minimal change disease
E. IgA nephropathy
D
Minimal change disease (lipoid nephrosis) is the most common cause of nephrotic syndrome in children under the age of 6 years. Proteinuria in these children is accompanied by essentially normal findings in the urinary sediment, which distinguishes minimal change disease from acute and membranoproliferative glomerulonephritis and IgA nephropathy. In contrast to membranous nephropathy, the disease responds well to corticosteroids.
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