Question

Nephrotic syndrome is the hallmark of the following primary kidney diseases EXCEPT

• A. Membranous glomerulopathy
• B. IgA nephropathy (Berger's disease)
• C. Minimal change disease
• D. Focal segmental glomerulosclerosis

Hint:

Think about which of these diseases classically causes blood in the urine rather than heavy protein loss.

Answer 1

The Correct Option is B

Step 1: Understanding the Question:
The question asks which primary glomerular disease does NOT typically present as nephrotic syndrome, from a list where the other three do.

Step 2: Key Concept or Approach:
Nephrotic syndrome, heavy proteinuria, hypoalbuminaemia, oedema and hyperlipidaemia, results from diseases that damage the glomerular basement membrane and podocyte barrier without much inflammation. Diseases with a more inflammatory, haematuria-predominant pattern present instead as nephritic syndrome.

Step 3: Working Through the Options:
Membranous glomerulopathy is a classic cause of nephrotic syndrome in adults, arising from immune complex deposition along the basement membrane. Minimal change disease is the most common cause of nephrotic syndrome in children, with diffuse podocyte foot-process effacement. Focal segmental glomerulosclerosis is another major nephrotic cause, especially in adults and in HIV-associated nephropathy. IgA nephropathy (Berger's disease), however, is the most common cause of primary glomerulonephritis worldwide, and it typically presents with episodic gross or microscopic haematuria, often following an upper respiratory infection, a nephritic rather than nephrotic pattern; only a minority of cases show nephrotic-range proteinuria.

Step 4: Conclusion:
The correct answer is IgA nephropathy, since it is primarily a nephritic disease, not a nephrotic one, unlike the other three listed diseases.