From the Research
The most likely cause of Minimal Change Disease (MCD) is unknown, but it is believed to be immune-mediated, involving T-cell dysfunction that leads to the release of cytokines or other factors that damage podocytes in the glomeruli of the kidneys, as suggested by the most recent study in 2023 1. The exact etiology of MCD remains unclear, but it is considered an idiopathic condition in most cases.
- MCD is characterized by intense proteinuria leading to edema and intravascular volume depletion, as described in a study published in 2017 2.
- The disease is more common in children, but can occur at any age, and is highly responsive to corticosteroids, as reported in a review published in 2006 3.
- The hallmark of MCD is the absence of visible structural changes in the glomeruli under light microscopy, with only foot process effacement visible on electron microscopy, which distinguishes it from other causes of nephrotic syndrome, as noted in a study published in 2017 2.
- In some cases, MCD can be triggered by certain medications, infections, allergic reactions, or malignancies, particularly Hodgkin's lymphoma, as mentioned in the example answer.
- Recent studies have explored the use of rituximab, a monoclonal antibody against CD20 B-lymphocytes, as a treatment option for MCD, with promising results, as reported in studies published in 2022 4 and 2011 5.
- However, the most recent and highest quality study, published in 2023 1, suggests that the pathobiology of MCD remains poorly understood, and further research is needed to determine the exact cause of the disease.
- The study published in 2023 1 found that T-cell receptor diversity did not differ between MCD active disease and remission states, and did not identify dominant clonotypes in MCD active disease, which suggests that the immune system may play a role in the development of MCD, but the exact mechanisms are still unclear.