Background and Aims

Membranous glomerulonephritis (MG) causes about 25% of nephrotic syndromes in the adult. Etiology is autoimmune and it is due to the deposit of anti-phospholipase A2 receptor (Anti-PLA2R) immune complexes in the glomerular basement membrane. Anti-PLA2R is highly specific for primary membranous glomerulonephritis (PMG).

The aim was to implement the Anti-PLA2R (ELISA) in our laboratory and study its correlation with PMG, being a request from the department of Nephrology, as our hospital hosts a reference center for transplants.

Methods

Values of Anti-PLA2R were determined in 40 patients by ELISA, using a commercialized kit (Anti-PLA2R ELISA (IgG), by EUROIMMUN, Germany). Patients’ age ranged from 18 to 80. 22 individuals with Systemic Lupus Erythematosus (SLE), Diabetes Mellitus or other autoimmune diseases, alongside 2 patients with known Anti-PLA2R positive PMG, formed the problem group. 20 of them had nephropathy or proteinuria. The other 16 were healthy controls or had no autoimmune disease.

Results

39 presented negative Anti-PLA2R levels, except for one with PMG, with similar levels to the previous ones (53.58 RU/ml) from an external laboratory. The second PMG patient had 8.84 RU/ml, lower than previous results, which could indicate a good control of the disease.

3 patients with MG and SLE had levels of <0.1 RU/ml, implying a secondary cause of the MG.

Conclusions

Anti-PLA2R detection by ELISA allows quantification, which is necessary for the long-term follow-up of PMG, as it correlates with clinical manifestations and biochemical data of the associated renal failure. It is also useful for the evaluation of transplanted patients with PMG.