Specimen Collection

3.5 mL SST Serum (Preferred)

5 mL Heparin Plasma

5 mL Plain Serum

3 mL Paediatric Micro-SST Serum
Reference Intervals

Uncertainty of measurement = 20%

Equivocal - Units: U/mL

Age Range	Either Sex
All	14 - 19

Negative

Age Range	Female
All	< 14

High

Age Range	Either Sex
<	>= 20

Turnaround Time: Between 1 week and 2 weeks
Diagnostic Use and Interpretation

About 80% of cases of membranous glomerulonephritis is primary (iMN) and 20% secondary to an undelying condition such as malignancy including carcinomas of the lung and colon, and melanoma (about 10% cases), Chronic infections (hepatitis B, hepatitis C, syphilis, schistosomiasis, malaria), drugs, SLE and other autoimmune conditions. [1]

In 2009 it was reported by Beck et al [2] that anti-PLA2R1 autoantibodies (PLA2R Ab) were present in 70% with iMN and not in patients with secondary disease.

Subsequent studies have shown that PLAR2 Ab have clinical utility in the following situations.

• To differentiate primary versus secondary membranous glomerulonephritis and therefore select those patients where a more extensive search for secondary causes maybe warranted
• Assist in deciding whether a patient should have treatment with immunosuppressive agents
• Assessing the response to and the on-going requirement for immunosuppression
• Assessing the risk of disease recurrence in patients being considered for or undergone renal transplantation.

References

1. Burstein, D.M., S.M. Korbet, and M.M. Schwartz, Membranous glomerulonephritis and malignancy. Am J Kidney Dis, 1993. 22(1): p. 5-10.

2. Beck, L.H., Jr., et al., M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med, 2009. 361(1): p. 11-21.

3. Ronco, P. and H. Debiec, Pathogenesis of membranous nephropathy: recent advances and future challenges. Nat Rev Nephrol, 2012. 8(4): p. 203-13.

4. Qin, W., et al., Anti-phospholipase A2 receptor antibody in membranous nephropathy. J Am Soc Nephrol, 2011. 22(6): p. 1137-43.

5. Svobodova, B., et al., Kidney biopsy is a sensitive tool for retrospective diagnosis of PLA2R-related membranous nephropathy. Nephrol Dial Transplant, 2013. 28(7): p. 1839-44.

6. Debiec, H. and P. Ronco, PLA2R autoantibodies and PLA2R glomerular deposits in membranous nephropathy. N Engl J Med, 2011. 364(7): p. 689-90.

7. Hofstra, J.M., et al., Anti-phospholipase A(2) receptor antibodies correlate with clinical status in idiopathic membranous nephropathy. Clin J Am Soc Nephrol, 2011. 6(6): p. 1286-91.

8. Michel, P.A., et al., Rituximab treatment for membranous nephropathy: a French clinical and serological retrospective study of 28 patients. Nephron Extra, 2011. 1(1): p. 251-61.

9. Debiec, H., et al., Autoantibodies specific for the phospholipase A2 receptor in recurrent and De Novo membranous nephropathy. Am J Transplant, 2011. 11(10): p. 2144-52.

10. Stahl, R., E. Hoxha, and K. Fechner, PLA2R autoantibodies and recurrent membranous nephropathy after transplantation. N Engl J Med, 2010. 363(5): p. 496-8.

Contact Information

For further information contact the laboratory, (09) 307 4949 ext 22103 or:
Associate Professor Rohan Ameratunga , Immunopathologist: Locator 93-5724,

Dr Richard Steele , or The LabPLUS Immunology Team

Last updated at 13:14:13 21/09/2020