What does light microscopy show in Minimal Change Disease?

• A. No visible cellular changes on light microscopy
• B. Diffuse mesangial proliferation
• C. Immune complex deposition
• D. Fibrin thrombi

Answer: (A)

Minimal Change Disease presents with nephrotic-range proteinuria while the glomeruli look essentially normal under light microscopy. The defining pathology is at the podocyte level, with effacement of foot processes seen on electron microscopy, not visible as cellular proliferation or immune deposits on light microscopy. That’s why light microscopy in this condition shows no visible cellular changes. Immunofluorescence is typically negative for immune complex deposition, and electron microscopy reveals the key lesion of foot process effacement. The other patterns—diffuse mesangial proliferation, immune complex deposition, or fibrin thrombi—point to different glomerular diseases and are not characteristic of Minimal Change Disease.