A 7-year-old boy presents with sudden-onset nephrotic syndrome. Vital signs show BP 128/82 mmHg, HR 98 bpm, RR 20/min, temp 37°C, SpO2 98% on room air. Laboratory studies reveal proteinuria 3.8 g/day, serum albumin 1.9 g/dL, lipiduria, normal serum creatinine (0.7 mg/dL), and normal complement C3 levels. Physical examination demonstrates bilateral ankle edema without hematuria. Renal biopsy shows foot process effacement on electron microscopy with absent immune deposits. Which of the following is the most appropriate initial treatment?
- A)ACE inhibitors alone
- B)CorticosteroidsGABARITO
- C)Observation and supportive care only
- D)Immediate dialysis initiation
- E)Cyclophosphamide and plasmapheresis
Explicação
Minimal change disease (MCD) is the most common cause of nephrotic syndrome in children, characterized by foot process effacement on EM with normal immune deposits. MCD is highly steroid-responsive; corticosteroids are first-line therapy with >90% remission ra... Ver explicação completa e trilha adaptativa →