Nepalese Army Institute of Health Sciences, Sanobharyang, Kathmandu, Nepal.
Department of Internal Medicine, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2022 Apr 15;60(248):399-401. doi: 10.31729/jnma.7433.
Minimal change disease is an important cause of nephrotic syndrome in children, however, few cases are seen among adults. There is very little literature regarding the occurrence of minimal change disease in adults. We reported a case of a 63-year-old male who presented with the complaint of swelling around the eyes mostly during the morning for 18 days and frothing of urine for 7 days. On examination, the patient was ill-looking and had edema around the eyes and over the ankles. After preliminary investigations, renal biopsy was performed and electron microscopy revealed diffuse effacement of foot processes of visceral epithelial cells suggesting minimal change disease (podocytopathy). The patient has been treated with tablet prednisolone 60 mg per oral once daily, tablet ramipril 2.5 mg per oral once daily, and tablet torsemide 20 mg per oral twice daily. Hence, minimal change disease should also be considered as a differential diagnosis in adults presenting with the features of nephrotic syndrome.
electron microscopy; minimal change disease; nephrotic syndrome; prednisolone.
微小病变性疾病是儿童肾病综合征的一个重要病因,但在成人中很少见。关于成人微小病变性疾病的发生,文献很少。我们报告了一例 63 岁男性患者,主要在早晨出现眼部肿胀,持续 18 天,并出现泡沫尿 7 天。检查时,患者面容憔悴,眼部和踝关节周围有水肿。初步检查后,进行了肾活检,电镜显示内脏上皮细胞足突弥漫性消失,提示微小病变性疾病(足细胞病)。患者接受了泼尼松龙片 60mg 口服,每日 1 次,雷米普利片 2.5mg 口服,每日 1 次,托塞米片 20mg 口服,每日 2 次治疗。因此,微小病变性疾病也应作为具有肾病综合征特征的成人的鉴别诊断。
电子显微镜;微小病变性疾病;肾病综合征;泼尼松龙。