What is the primary cause of minimal change disease?

Minimal change disease primarily arises from idiopathic causes, which means that the exact origin remains unknown. This condition primarily affects children and is characterized by nephrotic syndrome, where the glomeruli appear normal on light microscopy but show significant effacement of podocytes on electron microscopy.

Idiopathic cases suggest that there may be underlying immune mechanisms or alterations in T-cell function that lead to the disruption of the glomerular filtration barrier, resulting in proteinuria. While certain associations, such as viral infections, drugs, and systemic diseases, have been noted in some cases, they do not account for the vast majority of minimal change disease instances seen in pediatrics, hence the classification as idiopathic.

The other choices, such as viral infections or systemic diseases, may trigger similar renal presentations or have overlapping findings, but they do not constitute the primary cause of minimal change disease, as they are related to secondary causes or conditions rather than the disease itself.