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Abstract: FR-PO862

Levels of Anti-Phospholipase A2 Receptor Antibodies (PLA2R) in Patients with Membranous Nephropathy in Argentina

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Vilches, Antonio R., CEMIC, Buenos Aires, Argentina
  • Maria Elena, Biain, CEMIC, Buenos Aires, Argentina
  • Laham, Gustavo, CEMIC, Buenos Aires, Argentina
  • Diaz, Carlos H., CEMIC, Buenos Aires, Argentina
Background


Primary membranous glomerulopathy (NM) is the most common histological and immunohistochemical phenotype in adult non-diabetic nephrotic patients. 70% of untreated patients are positive for anti-PLA2R and this proportion is fairly constant
We analyzed the experience of a single Center of the levels of AntiPLA2R in patients with MN or with a nephrotic syndrome without a renal biopsy and correlated with the histological and immunohistochemical phenotype and the clinical status at the time of the assay

Methods

We identified 169 adult patients who had anti-PLA2R antibody levels determined using ELISA between July 2015 and November 2018 in Argentina. We obtained relevant data on 101 patients

Results

The median time between the dosing and the biopsy was 12.1 (2.8-45) months. Levels were positive in 30.6%, doubtful in 4.7% and negative in 64.7%, with no significant differences between positive or negative groups in terms of age, sex, initial presentation, albuminemia, proteinuria and renal function. In patients whose first dosage was performed within 6 months of the biopsy ( some had already started immunosuppressive treatment), the assay was positive in 45.5% and negative 54.3%. In the primary forms it was positive in 25, negative in 45 and doubtful in 4 patients. In secondary cases it was positive in only 1 patient and negative in 10
All patients with lupus MN were negative as were patients with other Glomerulopathies . Of four patients with a transplant who had a recurrence of MN in the graft 1 was positive, 1 had a doubtful result and 2 were negative All three pregnant women with a nephrotic syndrome were negative. In 12 patients the anti-PLA2 antibody titre decreased in response to immunosuppressive treatment (11) or spontaneous remission (1). Two patients who were negative in the course of a complete remission turned positive during a relapse

Conclusion

Our data show less positivity for anti-PLA2R than that reported in the literature in untreated patients with MN
This is likely due to the fact that many patients were in complete or partial remission, and that treatments mostly consisted of Ponticelli regimens which induce a quicker reduction of antibody levels than other therapeutic options
Our results are probably indicative of the wide spectrum of our sample in terms of clinical status and previous treatments