Minimal Change Disease — RACP Adult Medicine MCQ

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EasyNephrologyMinimal Change DiseaseRACP Adult Medicine

A 40-year-old man is diagnosed with new-onset nephrotic syndrome. Renal biopsy shows normal glomeruli on light microscopy, negative immunofluorescence, and diffuse podocyte foot process effacement on electron microscopy. What is the most likely diagnosis?

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Correct answer: A — Minimal change disease

Normal light microscopy, negative immunofluorescence, and diffuse podocyte foot process effacement on EM is the classic triad of minimal change disease (MCD). MCD is the most common cause of nephrotic syndrome in children and accounts for ~10-15% in adults. It is highly responsive to corticosteroids (prednisolone 1 mg/kg/day for 4-8 weeks then taper). Secondary causes (NSAIDs, lymphoma) should be considered in adults.

Reference: eTG – 2025 – Nephrology; KDIGO – 2021 – Glomerular Diseases Guidelines