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Abstract: TH-PO0727

Diagnostic Performance of the Commercially Available Enzyme-Linked Immunosorbent Assay (ELISA) Euroimmun Phospholipase A2 Receptor (PLA2R) Serum Antibody Test for Detection of Membranous Nephropathy: A Meta-Analysis

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Gankam Kengne, Fabrice, Centre Hospitalier EpiCURA asbl, Ath, Walloon Region, Belgium
  • Yengue Yengue Banag, Loïc Chedjou, Centre Hospitalier EpiCURA asbl, Ath, Walloon Region, Belgium
  • Goubella, Ahmed, Centre Hospitalier EpiCURA asbl, Ath, Walloon Region, Belgium
Background

Since its approval by EMA and FDA, the EUROIMMUN ELISA test for serum M-type phospholipase A2 receptor (sPLA2R-AB) has gained widespread interest and become the standard test for the serological diagnosis of idiopathic membranous nephropathy (iMN).
To date no metanalysis has investigated the overall performance of this particular test in the diagnosis of iMN form other nephropathies including secondary membranous nephropathy (sMN).
Here, we performed a meta-analysis assessing the performance of the EUROIMMUN sPLA2R-AB in iMN detection.

Methods

We searched the PUBMED literature from 2014 to 2024 with key words : Membranous nephropathy, PLA2R to identify eligible studies according to inclusion criteria (use of Euroimmun PLA2R test, exclusion of studies with immunosuppressive treatment before PLA2R testing).
We calculated overall sensitivity and specificity in the included studies, performed sensitivity analysis based on the cutoff used, ethnicity of patients included and calculated the overall specificity in distinguishing iMN from sMN.

Results

A total of 44 studies met the inclusion criteria. At the cutoff of 20IU vs 14IU/ ml , the overall sensitivity and specificity were respectively 65 and 97% vs 67% and 98% . For studies performed in Asia vs in the rest of the world sensitivity and specificity were respectively 64% and 97% vs 69% and 97%. For differentiating the iMN from sMN, overall specificity dropped to 88%.
Included studies displayed significant heterogeneity that persisted in the subgroup analysis but publication bias was not minimal.

Conclusion

EUROIMMUN serum ELISA PLA2R test is a valuable tool for the diagnosis of iMN. Its sensitivity and specificity is similar to those reported in previous metanalysis that included other serological diagnosis tests. Many studies identified a significant number of patients with sMN that tested positive for sPLA2R and very few patients with no MN tested positive for sPLA2R. The presence of sPLA2R AB in non iMN patients is extremely rare and additional studies are required to understand their clinical significance.

Funding

  • Clinical Revenue Support

Digital Object Identifier (DOI)