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Autoantibodies against phospholipase A2 receptor in Brazilian patients with glomerular diseases.

Abstract：

BACKGROUND:Recently, great progress has been made in understanding the pathogenesis of membranous nephropathy (MN) with the discovery of autoantibodies (Abs) to M-type phospholipase A2 receptor (PLA2R) in serum and in immunocomplexes deposited in glomerulus in most adult patients with primary MN. OBJECTIVE:To evaluate the diagnostic performance of anti-PLA2R in Brazilian patients with MN, as well as to verify the possible association of anti-PLA2R serum levels with disease activity. METHODS:117 patients with glomerular diseases confirmed by renal biopsy underwent routinely clinical and laboratory evaluation (serum creatinine and albumin, 24-h proteinuria, urinalysis, tests for etiological investigation) and determination of serum anti-PLA2R by ELISA. RESULTS:67.5% of the patients had MN, 9.4% focal segmental glomerulosclerosis, 7.7% lupus nephritis class V and 15.4%, other proteinuric glomerular diseases. The mean level of glomerular filtration rate (estimated by the CKD-EPI formula) was 79.43 mL/min (12.00-151.20 mL/min), 24 h proteinuria of 2.89 g (0-14.90 g), serum albumin of 3.79 g/dL (1.20-4.80 g/dL). Anti-PLA2R was detected in 27 patients, all with active MN, being 26 primary and 1 secondary MN. Sensitivity and specificity rates for the test were 60.5-94.7%, and positive (PPV) and negative (NPV) predictive values were 92.9 and 67.9%, respectively. CONCLUSIONS:Anti-PLA2R showed high specificity and PPV for the diagnosis of primary MN in Brazilian patients. There was a strong correlation between disease activity and positive anti-PLA2R. This biomarker represents an important diagnostic tool for primary MN and may contribute to the monitoring of disease activity in such patients.

journal_name

Int Urol Nephrol

journal_title

International urology and nephrology

authors

Santos Neto CO,Passos MT,Fernandes DE,Nishida SK,Andrade LEC,Mastroianni Kirsztajn G

doi

10.1007/s11255-020-02682-w

subject

Has Abstract

pub_date

2020-10-31 00:00:00

eissn

0301-1623

issn

1573-2584

pii

10.1007/s11255-020-02682-w

pub_type

杂志文章

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