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Application of glomerular PLA2R in the diagnosis of membranous nephropathy
Pages: 254-257
Year: Issue:  3
Journal: Journal of Southeast China National Defence Medical Science

Abstract: Objective To analyze serum anti-M-type phospholipase A2 receptor (PLA2R) antibodies and glomerular deposition of PLA2R and IgG subclass in patients with membranous nephropathy (MN), explore its diagnostic value in membranous nephropathy.Methods 79 cases diagnosed by renal biopsy as membranous nephropathy were selected, 65 patients with idiopathic membranous nephropathy and 14 patients with secondary membranous nephropathy (11 cases V-type lupus nephritis, 2 cases of hepatitis B virus-associated membranous nephropathy (HBV-MN), 1 case of syphilis-related membranous nephropathy).Serum anti-PLA2R antibody was detected by indirect immunofluorescence assay (IIFT), glomerular PLA2R and IgG subtclass by immunofluorescence, and clinical data difference of the two groups were compared.Results In 65 cases with IMN, 57 patients were glomerular PLA2R positive, and the positive ratio was 87.7%;47cases of serum anti PLA2R antibody were positive with the proportion of 72.3%;59 cases of IgG4 subclass were positive with the positive ratio of 90.8%.14 cases of glomerular PLA2R were negative.2 case of serum antibody PLA2R were positive, and the positive ratio was 14.3%.4 cases of IgG4 subclass were positive and the positive ratio was 28.6%.The sensitivity of glomerular PLA2R in diagnosing IMN was 87.7% and the specificity was 100%.The sensitivity of serum PLA2R in diagnosing IMN was 72.3% and the specificity was 85.7%.Positive ratio of glomerular PLA2R, serum PLA2R, IgG4 subclass in IMN patients was higher than in SMN.There was a statistically significant difference in sex composition between the two groups, Age, albumin, serum creatinine, total cholesterol, 24 hour proteinuria, and glomerular filtration rate were not significantly different.Conclusion Glomerular PLA2R has a high expression in IMN patients, which has a dominant role in the differential diagnosis of membranous nephropathy.
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