# Minimal Change Disease in an Adult With Secondary Hypogammaglobulinemia: A Case Report

## TL;DR

A 60-year-old woman with recurring infections was diagnosed with minimal change disease, which caused low immunoglobulin levels that improved with treatment.

## Contribution

This case report highlights the link between minimal change disease and secondary hypogammaglobulinemia in an adult patient.

## Key findings

- The patient's hypogammaglobulinemia improved as her proteinuria decreased with treatment.
- Minimal change disease can lead to immunoglobulin loss and impaired synthesis in adults.
- Corticosteroid treatment effectively managed the patient's condition and restored immunoglobulin levels.

## Abstract

Minimal change disease (MCD) is a common cause of nephrotic syndrome, particularly in children, but it also affects adults, albeit in smaller proportions. MCD presents with edema, severe proteinuria, hypoalbuminemia, and hyperlipidemia. MCD can lead to secondary hypogammaglobulinemia and an increased risk of infections by causing increased loss of immunoglobulins in the urine, impaired IgG synthesis, and from the immunosuppressive therapies used to treat MCD. The mainstay treatment for MCD is corticosteroids, which induce remission in most cases. However, some patients require other immunosuppressive therapies due to persistent relapses or resistance to standard treatment. This case report presents a 60-year-old woman with recurrent infections who was found to have hypogammaglobulinemia, with further workup showing nephrotic syndrome due to MCD. Her immunoglobulin levels normalized as her proteinuria levels improved with the treatment of her MCD.