An 18-year-old patient consulted for edema. A complete blood test showed proteinuria of 8 g/day without microhematuria, hypoalbuminemia and hypercholesterolemia with normal renal function. He was empirically administered corticosteroids. After one month, the clinical picture has completely disappeared. What is your diagnostic hypothesis?
We describe a young patient with criteria of nephrotic syndrome with excellent response to corticosteroids. Without biopsy, the clinical presentation and evolution suggest a nephropathy with minimal changes, which usually presents with normal or slightly altered renal function together with nephrotic syndrome, and which in 85-90% of cases resolves with steroid treatment. The age is the only data that is a bit shaky, since although it is the most frequent cause of idiopathic nephrotic syndrome in children and adolescents, it is usually recommended to perform a biopsy prior to treatment in those older than 16 years, in any case it does not admit much discussion.
Amyloidosis.
IgA nephropathy or Berger's disease.
Alport syndrome.
Nephropathy with minimal changes.
We describe a young patient with criteria of nephrotic syndrome with excellent response to corticosteroids. Without biopsy, the clinical presentation and evolution suggest a nephropathy with minimal changes, which usually presents with normal or slightly altered renal function together with nephrotic syndrome,