Pathogenesis (disease development)
The exact causes leading to minimal change glomerulonephritis (MCGN) are still unknown. An autoimmunologic component is thought to be involved. There is thought to be impaired T-cell activity (T-lymphocytes, or T-cells for short, form a group of white blood cells used for immune defense) and, as a consequence, dysfunction of podocytes (cells of the renal corpuscles).
The following factors may be associated with the disease:
- The term “minimal change” refers to the very slight changes seen in tissue sections of the kidney of affected individuals: The inconspicuous light microscopic image corresponding to a normal finding is characteristic.
- A light microscopic sign for the presence of MCGN are fatty deposits in the proximal parts of the tubular system (renal tubules or urinary tubules). This is explained by increased filtration of lipoproteins due to glomerular damage.
- Electron microscopy reveals a widening of the podocyte processes. This results in disruption of the architecture of the glomerular filter. Typically, podocytes are detached from the basement membrane at some sites.
Etiology (Causes)
Causes related to disease
- Hematologic neoplasms (blood cancers).
- Hodgkin’s disease (lymphogranulomatosis) – a malignant tumor of the lymphatic system.
- After atopic seizures in an allergy.
- After infections of various kinds, including HIV infection.
- Food allergy
- Non-Hodgkin’s lymphoma – malignant tumor of the lymphatic system that does not meet the diagnostic criteria of Hodgkin’s disease.
- Paraneoplastic (occurring alongside an existing cancer) syndromes – in various malignant tumors such as mesothelioma, renal, breast (breast cancer), colon (colon cancer) or pancreatic (pancreatic cancer).
Medication
- Interferon α – drugs with antiviral (directed against viruses), growth inhibitory and immunoregulatory properties.
- Lithium
- Non-steroidal anti-inflammatory drugs (NSAIDs) – painkillers such as ibuprofen.
- Penicillamine (chelating agents)
- Mercury
- Rifampicin – antibiotic (drug against bacterial infections).
Other causes
- After vaccinations
