Antibodies to m-type phospholipase A2 receptor in children with idiopathic membranous nephropathy
Vinod Kumar1, Raja Ramachandran1, Ashwani Kumar2
1Department of Nephrology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Abstract:
Idiopathic membranous nephropathy (IMN), the commonest cause of adult nephrotic syndrome (NS), accounts for only a minority of paediatric NS. Antibodies to m-type phospholipase A2 receptor (PLA2R) are seen in two-thirds of adult IMN cases. PLA2R staining in glomerular deposits is observed in 74% and 45% of adult and paediatric IMN cases, respectively. However, there are no reports of anti-PLA2R in paediatric IMN. We evaluated anti-PLA2R levels and PLA2R in gloemrular deposits in paediatric IMN seen at our center. Five cases were enrolled, all the cases stained for PLA2R in glomeruli and three (60%) had antibodies to PLA2R antigen. There was a parellel reduction in proteinuria and anti-PLA2R titer. The present report suggests that PLA2R has a contributory role in the pathogenesis of paediatric IMN.
Insights
Idiopathic membranous nephropathy (IMN) in children is rare, but this study found phospholipase A2 receptor (PLA2R) antibodies in 60% of cases. Reduced antibody levels correlated with decreased proteinuria, suggesting PLA2R
Area of Science:
- Nephrology
- Immunology
- Pediatrics
Background:
- Idiopathic membranous nephropathy (IMN) is the leading cause of nephrotic syndrome (NS) in adults, but less common in children.
- Antibodies to the phospholipase A2 receptor (PLA2R) are detected in a majority of adult IMN cases.
- Previous studies show PLA2R staining in glomerular deposits in both adult and pediatric IMN, but anti-PLA2R antibodies have not been reported in pediatric IMN.
Purpose of the Study:
- To investigate the presence and role of anti-PLA2R antibodies and PLA2R in pediatric IMN.
- To determine if anti-PLA2R antibodies contribute to the pathogenesis of IMN in children.
Main Methods:
- Retrospective analysis of five pediatric IMN cases.
- Evaluation of anti-PLA2R antibody titers.
- Immunohistochemical staining for PLA2R in kidney biopsy glomerular deposits.
Main Results:
- All five pediatric IMN cases showed PLA2R staining in glomeruli.
- Anti-PLA2R antibodies were detected in three out of five (60%) pediatric cases.
- A parallel reduction in proteinuria and anti-PLA2R antibody titers was observed.
Conclusions:
- PLA2R appears to play a role in the pathogenesis of pediatric IMN.
- The findings suggest that anti-PLA2R antibodies may be relevant in pediatric IMN, similar to adult cases.
- Further research is warranted to confirm these findings and explore therapeutic implications.
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