Antibodies to m-type phospholipase A2 receptor in children with idiopathic membranous nephropathy

Nephrology (Carlton). 2015 Aug;20(8):572-5. doi: 10.1111/nep.12478.

Abstract

Idiopathic membranous nephropathy (IMN), the commonest cause of adult nephrotic syndrome (NS), accounts for only a minority of paediatric NS. Antibodies to m-type phospholipase A2 receptor (PLA2R) are seen in two-thirds of adult IMN cases. PLA2R staining in glomerular deposits is observed in 74% and 45% of adult and paediatric IMN cases, respectively. However, there are no reports of anti-PLA2R in paediatric IMN. We evaluated anti-PLA2R levels and PLA2R in gloemrular deposits in paediatric IMN seen at our center. Five cases were enrolled, all the cases stained for PLA2R in glomeruli and three (60%) had antibodies to PLA2R antigen. There was a parellel reduction in proteinuria and anti-PLA2R titer. The present report suggests that PLA2R has a contributory role in the pathogenesis of paediatric IMN.

Keywords: glomerulonephritis; membranous nephropathy; nephrotic syndrome; tacrolimus.

MeSH terms

  • Adolescent
  • Age Factors
  • Autoantibodies / analysis*
  • Autoantibodies / blood
  • Biomarkers / blood
  • Biopsy
  • Child
  • Child, Preschool
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fluorescent Antibody Technique
  • Glomerulonephritis, Membranous / blood
  • Glomerulonephritis, Membranous / diagnosis
  • Glomerulonephritis, Membranous / drug therapy
  • Glomerulonephritis, Membranous / enzymology
  • Glomerulonephritis, Membranous / immunology*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney Glomerulus / enzymology
  • Kidney Glomerulus / immunology*
  • Kidney Glomerulus / pathology
  • Male
  • Nephrotic Syndrome / blood
  • Nephrotic Syndrome / diagnosis
  • Nephrotic Syndrome / drug therapy
  • Nephrotic Syndrome / enzymology
  • Nephrotic Syndrome / immunology*
  • Receptors, Phospholipase A2 / immunology*

Substances

  • Autoantibodies
  • Biomarkers
  • Immunosuppressive Agents
  • PLA2R1 protein, human
  • Receptors, Phospholipase A2