Drug-induced Minimal Change Disease



Drug-induced Minimal Change Disease


Anthony Chang, MD





Key Facts


Etiology/Pathogenesis



  • Common offending agents



    • Nonsteroidal anti-inflammatory drugs (NSAIDs)


    • Cyclooxygenase 2 inhibitors


    • Pamidronate


    • Interferon-α and interferon-β


    • Rifampin


Clinical Issues



  • Nephrotic syndrome


  • Treatment



    • Discontinue offending pharmacologic agent


Microscopic Pathology



  • Normal glomeruli by light microscopy


  • Diffuse podocyte foot process effacement


Top Differential Diagnoses



  • Minimal change disease


  • Focal segmental glomerulosclerosis







Jones methenamine silver reveals a normal glomerulus with delicate basement membranes and normal cellularity. Prominent podocyte protein droplets image correlate with severe proteinuria (13 g/d).






Electron micrograph reveals extensive effacement of the podocyte foot processes image in this glomerulus in a patient with severe proteinuria (17 g/d) after administration of nonsteroidal anti-inflammatory drugs.


TERMINOLOGY


Abbreviations



  • Minimal change disease (MCD)


ETIOLOGY/PATHOGENESIS


Implicated Drugs

Tags:
Jul 7, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Drug-induced Minimal Change Disease

Full access? Get Clinical Tree
Get Clinical Tree app for offline access