Inadequate treatment in a patient with minimal change disease (MCD) nephrotic syndrome: a case report

Abstract

Introduction: Minimal change disease (MCD) is the cause of primary nephrotic syndrome in about 90% of children but is rare in adults and only found in about 10% to 15% of adults. Adequate steroid therapy can lead to complete remission in more than 80% of adults with MCD nephrotic syndrome. This study aimed to report a case of an adult patient with nephrotic syndrome with renal biopsy results of MCD and her clinical improvement after adequate therapy with glucocorticoids. Case Presentation: We report a case of a female patient, 35 years old, who complained of swelling all over the body 3 months before admission. Previously, the patient was diagnosed with nephrotic syndrome on December 2020 and received oral steroid therapy that had been tapered down early, which caused the clinical symptoms to recur. The patient underwent a kidney biopsy, and MCD was found on histopathological examination. The patient received supportive therapy and resumed steroid therapy with adequate dosage. On the six-month follow-up, the patient was in complete remission. Conclusion: MCD is a nephrotic syndrome with a good prognosis, and 80% of patients will respond to adequate therapy. Our patient's previous medical history was re-evaluated, and concluded that the previous patient had received inadequate therapy. The patient has now reached a state of complete remission. This case highlighted the importance of adequate therapy in managing nephrotic syndrome.