Hello dear friends One case of my relatives came to me A 20 yrs unmarried female with c/o oedema over whole body since she was 2.5 yrs of age they consulted to a Dr and taken treatment after that she was obsulately fine after that again oedema started on 7 yrs of her age with pain in abd after treatment again all the oedema subsided again on 13 yrs of her age she started with same complaint and now she is 20 yrs and wt is 65 kg now c/o mild oedema over face and this oedema gows on increasing to whole the face and also in few days pedal oedema can be noticed menstural history is regular N/H/O ,DM /Thyriod/ TB/ no any familial history they are consulting to a nephrologist attaching blood reports and biopsy report plz have a look and suggest the further management

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Dear Ishwar, 1) This is a case of Mesangio proliferative Glomerulo Nephritis. With Positive IgM .MPGN. 2) Steroids are the main stay of the disease with tapering dose. 3) Salt restricted soft bland diet. 4) Remissions and Exacerbations are common. 5) May develop HTN, DM in future. May be steroid induced. 6) LSM is very important Diet Exercise. There is no permanent cure for this disease. 7) The causes may be Idiopathic Autoimmune Infections like Bacterial Viral Protozoal. This disease presents with Nephrotic Syndrome NS in more than 50 to 60 % of the cases. Prognosis. This depends on Nephrotic Syndrome& HTN at the time of presentation. Eventually they may progress to ESRD. Outcomes are not very favorable. Thanks again Ishwar.

Me sangria proliferation seen in 1.Minimal change disease 2 IgA nephropathy 3 Lupus nephropathy. This case is a variant of MCD with IgM deposit.Treatment like MCD.Refer to KDIGO guidelines avalable free online. long term prognosis depends on interstitial changes which is fine in your patient.

Right now it's in remission as proteins trace. What about role of ARB AND CILINDIPINE IN ADDITION To steroid to reduce proteinUria and prolong duration

These two have a very good role in preventing renal damage, can be started with low dose like 10 mg Olmesartan or 20 mg Telmisartan.

She is having nephrotic syndrome and that's the reason for peri orbital puffiness, final rx wud b renal transplantation, however, nephrologist will b in a better position to decide after biopsy, I wud suggest ZERO Salt diet for her and steroids!!

Mesangio proliferative glomerulonephritis, advised salt restriction, steroids in tapering doses.

It looks like congenital MPGN DISEASE STARTED at 2 . 5 yr

MPGN is always acquired only, may be autoimmune because it started early at 2 yrs. Certainly not congenital.

Thank you Dear Dr Krishna sir but may I know how can we controller or minimal the symptoms of this condition is there any way out like transplantation bcoz she will get married after few years so what can we do for future

Really, the problem is bit serious and not a favourable prognosis. They end up in ESRD. Before that they have to go for a kidney transplantation.

Thank you Dr Ahmed for your valuable answer

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