Figure 24

Light and electron microscopy in minimal change disease (lipoid nephrosis). A, This glomerulopathy, one of many associated with nephrotic syndrome, has a normal appearance on light microscopy. No evidence of antibody (immune) deposits is seen on immunofluorescence. B, Effacement (loss) of foot processes of visceral epithelial cells is observed on electron microscopy. This last feature is the major morphologic lesion indicative of massive proteinuria.

Minimal change disease is considered to be the result of glomerular capillary wall damage by lymphokines produced by abnormal T cells. This glomerulopathy is the most common cause of nephrotic syndrome in children (>70%) and also accounts for approximately 20% of adult patients with nephrotic syndrome. This glomerulopa-thy typically is a corticosteroid-responsive lesion, and usually has a benign outcome with respect to renal failure.

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