A 7-year-old boy presented with generalized edema. Urine examination revealed marked albuminuria. Serum biochemical examinations showed hypoalbuminemia with hyperlipidemia. Kidney biopsy was undertaken. On light microscopic examination, the kidney appeared normal. Electron microscopic examination is most likely to reveal:
Ans. is 'a' i.e. Fusion of foot process of the glomerular epithelial cellsRef Chandrasoma Taylor 3rd/e page 705, Robbins illustrated 6th/e, p956, Harrison 17th/Ep 1790 RepeatThe child in presenting with features S/o Nephrotic syndrome most frequent cause of which amongst children is minimal change ds.The light microscopic finding of MCD -no abnormalityElectron microscopic finding of MCD -fusion of foot processes of the glomerular epithelial cellsNote that loss of foot processes may also be seen in other proteinuric states (eg. Membranous glomerulonephritis, diabetes), but when the fusion is associated with normal glomeruli only then the diagnosis of MCD can be made.MCD is also known as lipoid nephrosis as cells of the proximal tubules are often laden with lipidsManifestations of nephrotic syndrome include*Massive proteinuria, with the daily loss of 3.5 gm or more of protein (less in children)Hypoalbuminemia with plasma albumin level less than 3 gm/dlGeneralized edemaHyperlipidemia and lipiduria
Fusion of foot processes of the glomerular epithelial cells
Rarefaction of glomerular basement membrane
Deposition of electron dense material in the basement membrane
Thin basement membrane