Minimal Change Disease Presenting as Nephrotic Syndrome in Early Pregnancy Complicated by Spontaneous Abortion: A Case Report

Background In a normal pregnancy there are significant physiological changes in renal haemodynamic causing mild proteinuria up to 300 mg/day. But proteinuria of > 3.5 g/day falls in the nephrotic-range. Case presentation We have presented a case of nephrotic syndrome (NS) in a 36-years-old Nepalese women, Gravida 2 Para 1 Living 1 (G2P1L1) presenting with a complaint of progressive lower limb edema and frothy urine during 8th weeks of pregnancy and spontaneous incomplete abortion at 10 + 3 weeks of gestation. On urine analysis albumin was 3+ and 24-hour urine protein was 5660 mg/day. She had dyslipidaemia and hypoalbuminemia. Following the abortion, renal biopsy was done to diagnose minimal change disease which was managed with steroids, diuretics, statins, and angiotensin receptor blockers. Discussion To the best of our knowledge, only a few cases of patients have presented with minimal change disease (MCD) during pregnancy, and two cases following abortion have been reported [4]. The temporal association of MCD, pregnancy and abortion observed in this case is considered as hypothesis-generating. Conclusion This case report emphasizes the importance of evaluating significant oedema and proteinuria in pregnancy for timely management.