jean robert
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A 2 yr old with leukemia develops nephrotic syndrome.LM studies are normal. EM studies demonstrate fusion of epithelial foot processes. The current hypothesis for the pathogenesis of this change is that it is secondary to which of the following?
a) Consumption
b) IgG directed against basement membrane
c) Immune complex deposition
d) Lymphokine production by T cells
e) Mesangial IgA deposition
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| mukho
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D?
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| Tiff
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D
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| new_n_lost
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d) Lymphokine production by T cells
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"never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| jean robert
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Well done, guys.
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| 1.ammara
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yes D. Minimal change disease
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| medikus
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Can anyone explain to me mechanism of Minimal change disease? Thanks
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| jean robert
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It is postulated that MCD is a disorder of T cells, which release a cytokine that injures the glomerular epithelial foot processes. This, in turn, leads to a decreased synthesis of polyanions. The polyanions constitute the normal charge barrier to the filtration of macromolecules, such as albumin. When the polyanions are damaged, leakage of albumin follows. The identity of this circulating permeability factor is uncertain, although it is postulated that it may be hemopexin.
Some of the cytokines that have been studied in MCD are interleukin-12 (IL-12) and interleukin-4 (IL-4). IL-12 levels have been found to be elevated in peripheral blood monocytes during the active phase and normalized during remission. Interleukin-18 (IL-18) can synergize with IL-12 to selectively increase the production of vascular permeability factor from T cells. In addition, levels of IL-4 and CD23 (a receptor for immunoglobulin E) have been found to be elevated in peripheral blood lymphocytes.
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| medikus
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Great explanation Jena, thanks so much!
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