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Profile of Indian Patients With Membranous Nephropathy

INTRODUCTION: The majority of primary membranous nephropathy (MN) cases are no longer considered idiopathic with the discovery of the podocytic autoantigens: phospholipase A2 receptor (PLA2R) and thrombospondin type 1 domain–containing 7A (THSD7A). Limited data on PLA2R-related MN in Indians exist i...

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Autores principales: Subramanian, Priyadarsani, Kumar, Hemanth, Tiwari, Bipin, Barwad, Adarsh, Bagchi, Soumita, Bagga, Arvind, Agarwal, Sanjay Kumar, Dinda, Amit Kumar, Singh, Geetika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7486174/
https://www.ncbi.nlm.nih.gov/pubmed/32954080
http://dx.doi.org/10.1016/j.ekir.2020.06.024
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author Subramanian, Priyadarsani
Kumar, Hemanth
Tiwari, Bipin
Barwad, Adarsh
Bagchi, Soumita
Bagga, Arvind
Agarwal, Sanjay Kumar
Dinda, Amit Kumar
Singh, Geetika
author_facet Subramanian, Priyadarsani
Kumar, Hemanth
Tiwari, Bipin
Barwad, Adarsh
Bagchi, Soumita
Bagga, Arvind
Agarwal, Sanjay Kumar
Dinda, Amit Kumar
Singh, Geetika
author_sort Subramanian, Priyadarsani
collection PubMed
description INTRODUCTION: The majority of primary membranous nephropathy (MN) cases are no longer considered idiopathic with the discovery of the podocytic autoantigens: phospholipase A2 receptor (PLA2R) and thrombospondin type 1 domain–containing 7A (THSD7A). Limited data on PLA2R-related MN in Indians exist in literature, and THSD7A-related MN remains undocumented in this population. We aimed to characterize the baseline PLA2R and THSD7A profile of adult and pediatric membranous nephropathy (MN) in a large Indian single-institution cohort. METHODS: A retrospective analysis of all cases of MN (primary and secondary) between 2014 and 2017 was performed with PLA2R direct immunofluorescence and THSD7A immunohistochemistry on the biopsies and anti-PLA2R enzyme-linked immunosorbent assay (ELISA) on baseline sera. RESULTS: MN constituted 10% of kidney biopsies received in the study period. A total of 216 cases with adequate tissue underwent PLA2R direct immunofluorescence, and 110 of them had available sera for PLA2R ELISA. Combining both testing methods, the prevalence of PLA2R-related primary MN was 72.8%, with moderate concordance between the 2 methods (kappa 0.61). PLA2R was also detected in 16.7% cases of secondary MN, most commonly lupus MN. THSD7A immunohistochemistry performed on 176 cases showed a prevalence of 3.4% in primary MN. One case of lupus MN was also positive for THSD7A. Dual positivity (PLA2R and THSD7A) was noted in 2 cases. The large pediatric cohort tested showed a prevalence of 44% of PLA2R based on tissue testing, whereas 1 case demonstrated THSD7A positivity. CONCLUSION: This study in a large cohort of Indian patients demonstrates prevalence rates of PLA2R- and THSD7A-related MN similar to world literature, including the substantial cohort of pediatric MN. It also confirms variation in MN in the form of outliers within PLA2R (related to tissue and serum testing), dual positivity for PLA2R and THSD7A, and PLA2R/THSD7A-positive secondary MN.
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spelling pubmed-74861742020-09-17 Profile of Indian Patients With Membranous Nephropathy Subramanian, Priyadarsani Kumar, Hemanth Tiwari, Bipin Barwad, Adarsh Bagchi, Soumita Bagga, Arvind Agarwal, Sanjay Kumar Dinda, Amit Kumar Singh, Geetika Kidney Int Rep Clinical Research INTRODUCTION: The majority of primary membranous nephropathy (MN) cases are no longer considered idiopathic with the discovery of the podocytic autoantigens: phospholipase A2 receptor (PLA2R) and thrombospondin type 1 domain–containing 7A (THSD7A). Limited data on PLA2R-related MN in Indians exist in literature, and THSD7A-related MN remains undocumented in this population. We aimed to characterize the baseline PLA2R and THSD7A profile of adult and pediatric membranous nephropathy (MN) in a large Indian single-institution cohort. METHODS: A retrospective analysis of all cases of MN (primary and secondary) between 2014 and 2017 was performed with PLA2R direct immunofluorescence and THSD7A immunohistochemistry on the biopsies and anti-PLA2R enzyme-linked immunosorbent assay (ELISA) on baseline sera. RESULTS: MN constituted 10% of kidney biopsies received in the study period. A total of 216 cases with adequate tissue underwent PLA2R direct immunofluorescence, and 110 of them had available sera for PLA2R ELISA. Combining both testing methods, the prevalence of PLA2R-related primary MN was 72.8%, with moderate concordance between the 2 methods (kappa 0.61). PLA2R was also detected in 16.7% cases of secondary MN, most commonly lupus MN. THSD7A immunohistochemistry performed on 176 cases showed a prevalence of 3.4% in primary MN. One case of lupus MN was also positive for THSD7A. Dual positivity (PLA2R and THSD7A) was noted in 2 cases. The large pediatric cohort tested showed a prevalence of 44% of PLA2R based on tissue testing, whereas 1 case demonstrated THSD7A positivity. CONCLUSION: This study in a large cohort of Indian patients demonstrates prevalence rates of PLA2R- and THSD7A-related MN similar to world literature, including the substantial cohort of pediatric MN. It also confirms variation in MN in the form of outliers within PLA2R (related to tissue and serum testing), dual positivity for PLA2R and THSD7A, and PLA2R/THSD7A-positive secondary MN. Elsevier 2020-07-02 /pmc/articles/PMC7486174/ /pubmed/32954080 http://dx.doi.org/10.1016/j.ekir.2020.06.024 Text en © 2020 International Society of Nephrology. Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical Research
Subramanian, Priyadarsani
Kumar, Hemanth
Tiwari, Bipin
Barwad, Adarsh
Bagchi, Soumita
Bagga, Arvind
Agarwal, Sanjay Kumar
Dinda, Amit Kumar
Singh, Geetika
Profile of Indian Patients With Membranous Nephropathy
title Profile of Indian Patients With Membranous Nephropathy
title_full Profile of Indian Patients With Membranous Nephropathy
title_fullStr Profile of Indian Patients With Membranous Nephropathy
title_full_unstemmed Profile of Indian Patients With Membranous Nephropathy
title_short Profile of Indian Patients With Membranous Nephropathy
title_sort profile of indian patients with membranous nephropathy
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7486174/
https://www.ncbi.nlm.nih.gov/pubmed/32954080
http://dx.doi.org/10.1016/j.ekir.2020.06.024
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