Minimal Change Nephrotic Syndrome (MCNS)
What is Minimal Change Nephrotic Syndrome?
Minimal Change Nephrotic Syndrome (MCNS) is a disorder characterized by massive proteinuria, hypoalbuminemia, edema (swelling of the body) and lipiduria (excess fats in the urine). It is a glomerulonephritis disorder which occurs mainly in children.
MCNS is also known as Nil Disease, which is why it is sometimes referred to as “insipidus,” a Latin word meaning “tasteless or dull.” In the United States, it is the most common form of Glomerulonephritis.
Symptoms of MCNS
The main symptoms of MCNS are:
- Frequent urination
- Protein in the urine or proteinuria
- Excess fluid retention in the body, leading to swelling of the lower extremities, face, abdomen, or hands
- Low levels of serum albumin and abnormally high levels of serum cholesterol
- High blood pressure
- Decreased urine output
Causes of MCNS
The exact cause of MCNS is unknown. However, it is believed that it is caused by an autoimmune response by the body's immune system, which mistakes the kidney for a foreign body and attacks the small blood vessels in the kidney. This causes a disruption in the normal functioning of the kidneys.
It is also believed that certain viral infections, such as measles, may trigger the immune system to react more aggressively. In addition, some researchers suggest that genetic factors may be involved.
Diagnosis of MCNS
A diagnosis of MCNS is made based on a physical examination, history, by laboratory testing, and imaging. A urinalysis and blood tests are typically performed to measure levels of protein, albumin, cholesterol, and other proteins.
Imaging may also be done to examine the kidneys, including Magnetic Resonance Imaging (MRI). A renal biopsy may also be performed to confirm the diagnosis.
Treatment of MCNS
The mainstay of treatment for MCNS is corticosteroids such as prednisone. Treatment with corticosteroids aims to reduce inflammation and proteinuria, the latter of which is critical in preventing further kidney damage.
In addition to corticosteroids, additional drugs such as ACE inhibitors or angiotensin receptor blockers are sometimes prescribed to control hypertension. Sometimes, other immunosuppressive medications such as cyclophosphamide are used if the disease is unresponsive to corticosteroids or if the patient cannot tolerate them.
Outlook for MCNS
Most people with MCNS have a good prognosis. It is important to follow the doctor's instructions for treatment to ensure the best outcome. With timely and appropriate treatment, it is possible to reduce swelling, decrease proteinuria, and improve cholesterol levels.