Abstract
Objective To observe the expression of serum anti-PLA2R antibody and analyze its clinical significance in patients with idiopathic membranous nephropathy (IMN). Methods A total of 36 patients with nephrotic syndrome were diagnosed as IMN by renal biopsy in our hospital from April 2015 to November 2016, and enrolled in the study. All these patients were treated with prednisone and cyclosporine A for 6 months. Creatinine clearance rate(Ccr), 24-hour total proteinuria(TUpro) and plasma albumin(Alb) were collected before and after treatment. Serum anti-PLA2R antibody was also assayed by enzyme-linked immuno sorbent assay (ELISA) at the same time. All the data were prepared for statistical analysis. Results Among the 36 patients with IMN, positive serum anti-PLA2R antibody in 28(77.7%) cases were found, and there were no significant differences in age, gender, prevalence of hypertension and type 2 diabetes mellitus between anti-PLA2R antibody positive and negative groups(P>0.05). The initial and post-therapeutic values of anti-PLA2R antibody was significantly correlated with corresponding values of both TUpro and serum albumin levels, respectively(P 0.05). In comparison with anti-PLA2R antibody negative group, there were significantly higher TUpro and lower Alb levels in anti-PLA2R antibody positive group (P 0.05). Twelve patients got anti-PLA2R antibody negative and 7 patients had complete remission in anti-PLA2R antibody positive group after treatment, all the 7 patients′ anti-PLA2R antibody became negative. Fore out of eight patients without anti-PLA2R antibody entered into complete remission, accounted for 50%. The prevalence of remission in anti-PLA2R antibody negative group was higher than that in anti-PLA2R antibody positive one, but there was no statistic significance(P>0.05). Conclusions The serum anti-PLA2R antibody by non-invasive technic is a specific biomarker for diagnosis of IMN. It is of tremendous significance for serum anti-PLA2R antibody to guide clinical diagnosis and predict prognosis in IMN patients. Key words: Glomerulonephritis, Membranous; Receptors, Phospholipase A2
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