Minimally variable nephropathy, also known as lipid-induced nephropathy, is one of the most common diseases leading to nephrotic syndrome. Accounting for about 75% of children with primary nephrotic syndrome, about 8 years of age children with nephrotic syndrome 70% to 80%. In adults are not uncommon, accounting for more than 16 years old patients with primary nephrotic syndrome, 15% to 20%.
Light microscopic glomerular normal, immunofluorescence examination generally no immune sediment, electron microscopy of diffuse epithelial foot process disappeared or fusion for its typical lesions. Sometimes the focal area of the mesangial area can be seen with electronic compacts. In the development of small lesions of nephropathy to the late development of focal sclerosis. Minimally variable nephropathy is sometimes seen under immunofluorescence in the mesangial area with IgM, IgA or C3 deposition, which is generally mild. Mesangial cell proliferation and IgM deposition occur at the same time, often suggesting a poor response to hormones or a delayed response to hormones, and increases the likelihood of disease progression.
Children peak age of 2 to 6 years old. Adults 30 to 40 years old more common, over the age of 60 patients with nephrotic syndrome, the incidence of small pathological nephropathy is also high Children in women for women 2 times the proportion of adult men and women are basically similar. About 1/3 of the patient before the disease may have upper respiratory tract or other infections. Most of the onset of more acute, typical cases of the first symptoms are mostly nephrotic syndrome, accounting for 90% of children with nephrotic syndrome, adult 20%. Normal blood pressure. 20% of patients can see different degrees of microscopic hematuria, with age, microscopic hematuria incidence also increased, especially in patients over 60 years of age, due to renal interstitial inflammation fibrosis and vascular disease, microscopic incidence of hematuria higher. But the flesh and blood is rare. Due to low blood volume and renal perfusion decreased, about 1/3 of the first time the patient may have glomerular filtration rate decreased. Urine sediment examination without cell or tube type. In severe cases 24 hours urine protein can exceed 40g. Urinary protein in children is a typical high-selective proteinuria, including albumin and a very small amount of high molecular weight proteins such as IgG, α2-macroglobulin, C3, adults are different, over 60 years old patients with minor lesions Kidney disease can be expressed as non-selective proteinuria, and often accompanied by decreased blood pressure and glomerular filtration rate. In recent years found that the molecular weight of 88000 transferrin, because of its spherical structure characteristics, but also with albumin leakage to the renal tubular fluid, pH in the urine of 4.5 to 5.5, transferrin iron will be free to the renal tubular fluid , Fe3 + can produce many oxygen free radical damage renal interstitial tubules, and Fe3 + can also directly damage the renal tubules and stroma. Urine without fibrinolysis products and C3. Blood complement component normal, but may have a slight decline in C1q. The IgG concentration in the episodes was generally low, while IgM was slightly elevated during the onset and remission periods.
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