Findings which are not typical in minimal change disease in a child:
(1) age of onset < 1 year of age
(2) positive family history
(3) presence of anemia, skin rash, arthritis or other extra-renal complaints
(4) hypertension, pulmonary edema or other signs of expansion in the intra-vascular volume
(5) renal failure with elevation in serum creatinine
(6) red blood cell casts or gross hematuria
(7) failure of proteinuria to respond to 8 weeks of corticosteroid therapy
(8) presence of a disease associated with nephrotic syndrome (viral hepatitis, drugs, autoimmune disease, leukemia, lymphoma, etc.)
where:
• About a quarter of patients with minimal change disease will have persistent microscopic hematuria.
• Hypertension may be seen in 5-7% of children (it is seen more often in adults).
• Elevations in serum BUN are common.
If a patient has one or more of these findings:
(1) an alternative diagnosis should be considered
(2) performance of a renal biopsy should be considered
