A 5 year old boy is suffering from mimimal change nephrotic syndrome. For bringing about a remission induction, the drug of choice is
**Core Concept**
Minimal change disease (MCD) is a common cause of nephrotic syndrome in children, characterized by the loss of foot processes of podocytes and normal glomerular histology under light microscopy. The disease is associated with an overactive immune response, leading to the production of various cytokines and growth factors that contribute to the disease process.
**Why the Correct Answer is Right**
The drug of choice for inducing remission in minimal change disease is corticosteroids, specifically prednisolone. Corticosteroids work by suppressing the immune response and reducing the production of cytokines and growth factors that contribute to the disease process. They also have a direct effect on the podocytes, reducing proteinuria and allowing the kidneys to recover. The exact mechanism of action involves the inhibition of T-cell activation and the reduction of pro-inflammatory cytokines such as IL-1 and TNF-α.
**Why Each Wrong Option is Incorrect**
* **Option B:** Cyclophosphamide is an immunosuppressive agent used in the treatment of various autoimmune diseases, including nephrotic syndrome. However, it is not the first-line treatment for minimal change disease and is usually reserved for patients who do not respond to corticosteroids.
* **Option C:** Cyclosporin is an immunosuppressive agent used in the treatment of autoimmune diseases, including renal transplant rejection. It is not typically used as a first-line treatment for minimal change disease.
* **Option D:** Azathioprine is an immunosuppressive agent used in the treatment of autoimmune diseases, including renal diseases. However, it is not the first-line treatment for minimal change disease and is usually reserved for patients who do not respond to corticosteroids.
**Clinical Pearl / High-Yield Fact**
It is essential to note that the goal of treatment in minimal change disease is to induce complete remission, which is defined as the resolution of proteinuria and hematuria, and the return of the kidneys to normal function. Corticosteroids are the mainstay of treatment, and patients who do not respond to corticosteroids may require additional immunosuppressive therapy.
**Correct Answer:** C. Prednisolone