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10.1111/ajt.13133

http://scihub22266oqcxt.onion/10.1111/ajt.13133
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C4472303!4472303!25766759
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suck abstract from ncbi


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pmid25766759      Am+J+Transplant 2015 ; 15 (5): 1349-59
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  • Anti-Phospholipase A2 Receptor Antibodies in Recurrent Membranous Nephropathy #MMPMID25766759
  • Kattah A; Ayalon R; Beck LH; Sandor DG; Cosio FG; Gandhi MJ; Sethi S; Lorenz EC; Salant DJ; Fervenza FC
  • Am J Transplant 2015[May]; 15 (5): 1349-59 PMID25766759show ga
  • About 70% of patients with primary membranous nephropathy (MN) have circulating anti-phospholipase A2 receptor (PLA2R) antibodies that correlate with disease activity, but their predictive value in post-transplant (Tx) recurrent MN is uncertain. We evaluated 26 patients, 18 with recurrent MN and 8 without recurrence, with serial post-Tx serum samples and renal biopsies to determine if patients with pre-Tx anti-PLA2R are at increased risk of recurrence as compared to seronegative patients and to determine if post-Tx changes in anti-PLA2R correspond to the clinical course. In the recurrent group, 10/17 patients had anti-PLA2R at the time of Tx vs. 2/7 patients in the non-recurrent group. The positive predictive value of pre-Tx anti-PLA2R for recurrence was 83%, while the negative predictive value was 42%. Persistence or reappearance of post-Tx anti-PLA2R was associated with increasing proteinuria and resistant disease in many cases; little or no proteinuria occurred in cases with pre-Tx anti-PLA2R and biopsy evidence of recurrence in which the antibodies resolved with standard immunosuppression. Some cases with positive pre-Tx anti-PLA2R were seronegative at the time of recurrence. In conclusion, patients with positive pre-Tx anti-PLA2R should be monitored closely for recurrent MN. Persistence or reappearance of antibody post-Tx may indicate a more resistant disease.
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