A 5-year-old boy is brought to the physician because of facial swelling that started 5 days ago. Two weeks ago, he had a sore throat that resolved spontaneously. His temperature is 37.0°C (98.6°F), pulse is 107/min, and blood pressure is 94/67 mm Hg. Examination shows pitting edema of the upper and lower extremities as well as periorbital edema. The abdomen is mildly distended. Urinalysis shows 4+ protein and negative blood. Multiple regions of the kidney are biopsied, and a representative image is shown below: Which of the following is the most likely diagnosis?

Question

A 5-year-old boy is brought to the physician because of facial swelling that started 5 days ago. Two weeks ago, he had a sore throat that resolved spontaneously. His temperature is 37.0°C (98.6°F), pulse is 107/min, and blood pressure is 94/67 mm Hg. Examination shows pitting edema of the upper and lower extremities as well as periorbital edema. The abdomen is mildly distended. Urinalysis shows 4+ protein and negative blood.  Multiple regions of the kidney are biopsied, and a representative image is shown below:  Which of the following is the most likely diagnosis?

Quizplus · Accepted Answer

Eductional Objective: Minimal change disease is the most common cause of nephrotic syndrome in children.  It is often idiopathic but may be triggered by drugs, immunizations, or malignancy.  Light microscopy shows normal glomeruli, with no immunoglobulin or complement deposits on immunofluorescent staining.  However, electron microscopy shows diffuse podocyte foot process effacement and fusion.

A 5-Year-Old Boy Is Brought to the Physician Because of Facial