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Nephrotic syndrome — MRCPCH FOP MCQ

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HardRenalNephrotic syndromeMRCPCH FOP

A 4-year-old boy has periorbital swelling, ankle oedema and frothy urine. Urine dipstick shows protein 4+, serum albumin is 18 g/L and blood pressure is normal. What is the most likely diagnosis?

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Correct answer: E — Minimal change nephrotic syndrome

Heavy proteinuria, oedema, hypoalbuminaemia and normal blood pressure in a preschool child are typical of minimal change nephrotic syndrome. Post-streptococcal glomerulonephritis more often causes haematuria and hypertension. Haemolytic uraemic syndrome would include anaemia, thrombocytopenia and acute kidney injury. The pearl is that nephrotic syndrome is a hypercoagulable and infection-prone state.

Reference: NICE CKS Nephrotic syndrome; UK Kidney Association/BAPN guidance