BACKGROUND: The recent finding that phospholipase-A(2)-receptor antibodies (PLA(2)R-AB) may play a role in the development of primary membranous glomerulonephritis (MGN) offers the opportunity to measure a marker to help diagnose, classify and eventually monitor the course of patients with MGN. METHODS: We developed an immunofluorescence test, which allows the easy and specific analysis of the presence of PLA(2)R-AB in serum. The usefulness of this test was studied in 153 healthy blood donors, 90 patients with non-membranous glomerular injuries, 17 patients with a secondary form of MGN and 100 patients with biopsy-proven primary MGN. In addition, in five patients with biopsy-proven MGN, PLA(2)R-AB levels were monitored prospectively for up to 18 months following a single dose of rituximab (RTX) (375 mg/m(2) body surface). RESULTS: PLA(2)R-AB were not found in healthy controls or patients with glomerular lesions other than biopsy-proven primary MGN. Fifty-two patients with primary MGN (52%) were positive for PLA(2)R-AB. The levels ranged from 1:10 to 1:3200. In patients who had MGN and were treated with RTX the fall in PLA(2)R-AB levels was followed by a decrease in proteinuria, whereas an increase in PLA(2)R-AB levels was associated with an increase in proteinuria. CONCLUSIONS: These studies show that the new test allows the monitoring of PLA(2)R-AB levels in patients with MGN and may help in making therapeutic decisions for these patients.
BACKGROUND: The recent finding that phospholipase-A(2)-receptor antibodies (PLA(2)R-AB) may play a role in the development of primary membranous glomerulonephritis (MGN) offers the opportunity to measure a marker to help diagnose, classify and eventually monitor the course of patients with MGN. METHODS: We developed an immunofluorescence test, which allows the easy and specific analysis of the presence of PLA(2)R-AB in serum. The usefulness of this test was studied in 153 healthy blood donors, 90 patients with non-membranous glomerular injuries, 17 patients with a secondary form of MGN and 100 patients with biopsy-proven primary MGN. In addition, in five patients with biopsy-proven MGN, PLA(2)R-AB levels were monitored prospectively for up to 18 months following a single dose of rituximab (RTX) (375 mg/m(2) body surface). RESULTS: PLA(2)R-AB were not found in healthy controls or patients with glomerular lesions other than biopsy-proven primary MGN. Fifty-two patients with primary MGN (52%) were positive for PLA(2)R-AB. The levels ranged from 1:10 to 1:3200. In patients who had MGN and were treated with RTX the fall in PLA(2)R-AB levels was followed by a decrease in proteinuria, whereas an increase in PLA(2)R-AB levels was associated with an increase in proteinuria. CONCLUSIONS: These studies show that the new test allows the monitoring of PLA(2)R-AB levels in patients with MGN and may help in making therapeutic decisions for these patients.
Authors: Nicola M Tomas; Laurence H Beck; Catherine Meyer-Schwesinger; Barbara Seitz-Polski; Hong Ma; Gunther Zahner; Guillaume Dolla; Elion Hoxha; Udo Helmchen; Anne-Sophie Dabert-Gay; Delphine Debayle; Michael Merchant; Jon Klein; David J Salant; Rolf A K Stahl; Gérard Lambeau Journal: N Engl J Med Date: 2014-11-13 Impact factor: 91.245
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Authors: A Radice; F Pieruzzi; B Trezzi; G Ghiggeri; P Napodano; M D'Amico; T Stellato; R Brugnano; F Ravera; D Rolla; G Pesce; M E Giovenzana; F Londrino; V Cantaluppi; F Pregnolato; A Volpi; G Rombolà; G Moroni; G Ortisi; Renato A Sinico Journal: J Nephrol Date: 2017-10-28 Impact factor: 3.902
Authors: Caroline M F Barrett; Megan L Troxell; Christopher P Larsen; Donald C Houghton Journal: Int Urol Nephrol Date: 2013-11-12 Impact factor: 2.370
Authors: A Kattah; R Ayalon; L H Beck; S Sethi; D G Sandor; F G Cosio; M J Gandhi; E C Lorenz; D J Salant; F C Fervenza Journal: Am J Transplant Date: 2015-03-12 Impact factor: 8.086