A 5-year-old boy is brought to the emergency department with complaints of generalized swelling and decreased urine output over the past few days. His mother reports that he had periorbital puffiness in the mornings, which progressed to swelling in his legs and abdomen. He has no history of fever, sore throat, or recent illness. On examination, he has pitting edema, mild ascites, and normal blood pressure. Urinalysis reveals heavy proteinuria (4+), no hematuria, and microscopic examination shows no casts. Blood tests show hypoalbuminemia (1.7 g/dL) and hyperlipidemia. Which of the following is most characteristic of this disease?
