Question
Loss of foot processes is classical in which of the following conditions?
| A. |
Membranous glomerulitis
|
| B. |
Minimal Change Disease
|
| C. |
Diabetic nephropathy
|
| D. |
None of the above
|
Show Answer
|
Correct Answer » B
Explanation
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|
–Podocyte foot processes interdigitate and cover the glomerular basement membrane (GBM).
– They form the slit diaphragm, key for selective filtration.
– Loss/effacement → altered permeability → proteinuria.
– Minimal Change Disease (MCD) shows diffuse podocyte foot process effacement on electron microscopy.
– Presents with nephrotic syndrome: massive proteinuria, hypoalbuminemia, edema.
– Light microscopy often normal; diagnosis needs electron microscopy.
– Podocyte injury causes selective albuminuria.
– Membranous glomerulonephritis shows thickened capillary walls & subepithelial immune deposits;
foot process effacement may occur but is not classical.
– Immune complex deposits are key lesions (seen by immunofluorescence & EM).
– Diabetic nephropathy features GBM thickening & mesangial expansion.
– Podocyte foot process loss occurs late, not early.
– Early hallmark: Kimmelstiel-Wilson nodules, not foot process effacement.
