Minimal change

• Commonest cause of nephrotic syndrome in children

Aetiology

• Idiopathic
• Hodgkin’s lymphoma
• Leukaemia
• Virus

Clinical features

• Facial/generalised oedema
• Heavy proteinuria - nephrotic syndrome

Investigations

• Electron microscopy: foot process fusion
• Light microscopy: normal
• Immunofluorescence: normal

Management and prognosis

• 94% complete remission with oral steroids
• Some are steroid resistant or dependent, or have multiple relapses
• Second line - cyclophosphamide, monoclonal antibodies e.g. retuximab
• Does not cause progressive renal failure