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Nephrotic syndrome — RACP Paediatrics MCQ

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ModerateRenalNephrotic syndromeRACP Paediatrics

A 4-year-old develops periorbital oedema and ankle swelling after a viral illness. Urine dipstick shows 4+ protein and no blood; serum albumin is 18 g/L, creatinine and complement are normal. What is the most likely diagnosis?

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Correct answer: E — Minimal change nephrotic syndrome

Heavy proteinuria, hypoalbuminaemia and oedema with normal complement and renal function in a young child are typical of minimal change nephrotic syndrome. Post-streptococcal GN usually has haematuria, hypertension and low complement. The pearl is that infection risk and thrombosis risk should be considered in nephrotic syndrome, not just oedema control.

Reference: RCH Clinical Practice Guidelines: Nephrotic syndrome; Therapeutic Guidelines (eTG)