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Profile of Indian Patients With Membranous Nephropathy
- Source :
- Kidney International Reports, Vol 5, Iss 9, Pp 1551-1557 (2020), Kidney International Reports
- Publication Year :
- 2020
- Publisher :
- Elsevier, 2020.
-
Abstract
- Introduction The majority of primary membranous nephropathy (MN) cases are no longer considered idiopathic with the discovery of the podocytic autoantigens: phospholipase A2 receptor (PLA2R) and thrombospondin type 1 domain–containing 7A (THSD7A). Limited data on PLA2R-related MN in Indians exist in literature, and THSD7A-related MN remains undocumented in this population. We aimed to characterize the baseline PLA2R and THSD7A profile of adult and pediatric membranous nephropathy (MN) in a large Indian single-institution cohort. Methods A retrospective analysis of all cases of MN (primary and secondary) between 2014 and 2017 was performed with PLA2R direct immunofluorescence and THSD7A immunohistochemistry on the biopsies and anti-PLA2R enzyme-linked immunosorbent assay (ELISA) on baseline sera. Results MN constituted 10% of kidney biopsies received in the study period. A total of 216 cases with adequate tissue underwent PLA2R direct immunofluorescence, and 110 of them had available sera for PLA2R ELISA. Combining both testing methods, the prevalence of PLA2R-related primary MN was 72.8%, with moderate concordance between the 2 methods (kappa 0.61). PLA2R was also detected in 16.7% cases of secondary MN, most commonly lupus MN. THSD7A immunohistochemistry performed on 176 cases showed a prevalence of 3.4% in primary MN. One case of lupus MN was also positive for THSD7A. Dual positivity (PLA2R and THSD7A) was noted in 2 cases. The large pediatric cohort tested showed a prevalence of 44% of PLA2R based on tissue testing, whereas 1 case demonstrated THSD7A positivity. Conclusion This study in a large cohort of Indian patients demonstrates prevalence rates of PLA2R- and THSD7A-related MN similar to world literature, including the substantial cohort of pediatric MN. It also confirms variation in MN in the form of outliers within PLA2R (related to tissue and serum testing), dual positivity for PLA2R and THSD7A, and PLA2R/THSD7A-positive secondary MN.<br />Graphical abstract
- Subjects :
- medicine.medical_specialty
Concordance
PLA2R
Population
030232 urology & nephrology
Prevalence
030204 cardiovascular system & hematology
thrombospondin
lcsh:RC870-923
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Membranous nephropathy
Clinical Research
Internal medicine
medicine
education
Direct fluorescent antibody
education.field_of_study
Systemic lupus erythematosus
business.industry
membranous nephropathy
medicine.disease
lcsh:Diseases of the genitourinary system. Urology
THSD7A
Nephrology
Cohort
Immunohistochemistry
ELISA
business
Subjects
Details
- Language :
- English
- ISSN :
- 24680249
- Volume :
- 5
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Kidney International Reports
- Accession number :
- edsair.doi.dedup.....d9d784967beb02dc335546a7da3af3f9