MCQ Pediatrics Answer 40

The correct answer is D.

The child is suffering from minimal change or nil disease (lipoid nephrosis), which has a peak incidence at 2-3 years of age. Minimal change disease can be associated with food allergies, medications, or hematologic malignancies, or it can occur idiopathically. The pathology does not appear to involve complement, immunoglobulins, or immune complex deposition. Rather, an altered cell-mediated immunologic response with abnormal secretion of lymphokines by T cells is thought to reduce the production of anions in the glomerular basement membrane, thereby increasing the glomerular permeability to plasma albumin through a reduction of electrostatic repulsion. The loss of anionic charges is also thought to favor foot process fusion. Some authors have noted that other conditions associated with T-cell abnormalities, such as Hodgkin's disease and T-cell lymphoma, are sometimes associated with minimal change disease.

Consumption of complement factors (choice A) is observed in many conditions in which complement activation occurs, for example, membranoproliferative glomerulonephritis.

IgG directed against renal and pulmonary basement membranes (choice B) is found in Goodpasture's syndrome, a cause of rapidly progressive glomerulonephritis and hemoptysis.

Immune complex deposition (choice C) is associated with type III hypersensitivity reactions, including postinfectious glomerulonephritis, lupus nephritis, Henoch-Schönlein purpura, cryoglobulinemia, and bacterial endocarditis.

Mesangial IgA deposition (choice E) is associated with Berger's disease, or IgA nephropathy, a cause of glomerulonephritis.

Category: Pediatrics MCQs