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Pathogenesis

Authoring team

The pathogenesis of minimal change disease is unknown. It is suggested that cell-mediated immune reactions to kidney antigens, with subsequent cytokine release, are important.

The supporting evidence is largely circumstantial:

  • MCD responds dramatically to immunosuppression e.g. steroid therapy, cyclosporin and cyclophosphamide
  • MCD may be associated with Hodgkin's disease in which abnormalities of cellular immunity are well established
  • MCD may show spontaneous improvement in infections that depress cellular immunity, for example, measles

The cytokines are thought to increase glomerular permeability by altering the charge distribution along the glomerular basement membrane.

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