Clinical significance and long-term evolution of minimal change histopathologic variants and of IGM nephropathy among Egyptians

In children, the most frequent idiopathic nephrotic syndrome is minimal cha nge nephrotic syndrome (MCNS), Typically, MCNS shows no abnormalities by li ght microscopy: "nil disease". Beside this classic picture, there are other minor light microscopic abnormalities which are considered as MCNS variant s. Our 172 MCNS patients were divided into a nil disease group, two groups of MCNS variants (mild mesangial hypercellularity and mild mesangial thicke ning) and a fourth group Frith normal light microscopy and diffuse IgM depo sition (IgM nephropathy group), The relation of this fourth group to MCNS i s controversial in the literature. Age and serum creatinine were significan tly different in the four histologic groups (P=0.03 for age and 0.047 for s erum creatinine), Comparing the groups in pairs, it appeared that these sig nificant differences were due to significantly higher age and serum creatin ine in the mild mesangial hypercellularity group than in the IgM nephropath y group (P = 0.02 for age and 0.01 for serum creatinine), The groups were s imilar as regards follow-up creatinine clearance and early and late steroid response. We concluded that mild mesangial hypercellularity may differ fro m other MCNS forms as regards age at presentation and renal function. We al so suggest that IgM nephropathy with normal light microscopy is similar to MCNS.