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2017 ; 7
(1
): 1-9
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Immunohistochemical Glomerular Expression of Phospholipase A2 Receptor in Primary
and Secondary Membranous Nephropathy: A Retrospective Study in an Indian Cohort
with Clinicopathological Correlations
#MMPMID28413416
Roy S
; Korula A
; Basu G
; Jacob S
; Varughese S
; Tamilarasi V
Nephron Extra
2017[Jan]; 7
(1
): 1-9
PMID28413416
show ga
BACKGROUND: Limited published literature exists on the utility and
standardization of anti-phospholipase A2 receptor (anti-PLA2R)
immunohistochemistry (IHC) for the diagnosis of primary membranous nephropathy
(MN). The study aimed to validate anti-PLA2R IHC for the diagnosis of primary MN
and clinicopathological correlations in an Indian cohort. METHODS: Subjects
included patients with primary and secondary MN diagnosed between January 2012
and August 2014 with an adequate renal biopsy and at least 1 year of clinical
follow-up. Anti-PLA2R IHC was performed in all cases with miscellaneous renal
lesions as controls. Electron microscopy was performed in selected cases.
Sensitivity and specificity of anti-PLA2R IHC to identify primary MN was
evaluated. Histopathological analyses of primary and secondary MN were done with
clinicopathological correlations including serum creatinine, eGFR, chronic kidney
disease stage, 24-h urine protein, serum cholesterol, serum albumin, and
hypertension at presentation and follow-up, using the Kruskal-Wallis test and
Spearman rank correlation. A p value of ?0.05 was considered statistically
significant. RESULTS: In 153 MN patients (99 primary, 54 secondary) and 37
miscellaneous controls, anti-PLA2R IHC differentiated primary from secondary MN
with a sensitivity of 70.2% and a specificity of 96.6%. Secondary MN had
increased mesangial matrix expansion compared to primary MN (p = 0.001). Severe
nephrotic syndrome, impaired renal function, and hypertension were all more
common in primary than in secondary MN. CONCLUSION: Anti-PLA2R IHC is a specific
marker to distinguish primary MN from secondary MN.