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2017 ; 27
(5
): 353-358
Nephropedia Template TP
gab.com Text
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English Wikipedia
Immunohistochemical Analysis of Anti-phospholipase A2 Receptor Antibody on Renal
Biopsies: A Single Tertiary Care Center Study
#MMPMID28904430
Gudipati A
; Uppin MS
; Kalidindi RK
; Swarnalatha G
; Das U
; Taduri G
; Raju SB
; Rajasekhar L
; Prayaga AK
Indian J Nephrol
2017[Sep]; 27
(5
): 353-358
PMID28904430
show ga
Membranous nephropathy (MN) is one of the common cause of nephrotic syndrome. The
discrimination between primary MN (iMN) and secondary MN is essential because of
treatment implications. Immunohistochemical (IHC) evaluation with the help of
anti-phospholipase A2 receptor (PLA2R) antibody helps in tissue evaluation of
iMN, which is an easy, cost-effective, and pathologist-friendly technique. The
study included 82 cases of MN over a period of 3 years. IHC using PLA2R antibody
was performed on iMN and secondary cases with adequate tissue. Cases of minimal
change disease (MCD) were included as control. Granular staining along the
basement membrane in the absence of staining of podocytes was considered
positive. Medical records were verified for clinical information, baseline
biochemical parameters, details of viral markers, connective tissue disease
profile, and basic imaging workup. Of the 82 cases of MN, 51 were iMN and 31
secondary MN (sMN). Thirteen MCD cases were included as control. IHC with PLA2R
antibody showed a sensitivity of 91.8% and specificity of 95.1%, positive
predictive value of 95.7%, and negative predictive value of 90.7% in the
diagnosis of iMN. The other parameters, either clinical or laboratory, did not
show significant differences between iMN and sMN groups. The results of PLA2R
staining by IHC were comparable with other studies and showed a higher
sensitivity (91.8%) and specificity (95.1%). IHC with anti-PLA2R antibody can be
considered as the standard diagnostic approach to identify iMN and offer scope
for individualized treatment.