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Treatment of Membranous Nephropathy in Patients With THSD7A Antibodies Using Immunoadsorption

Julia Weinmann-Menke1, Stefan Holtz1, Daniel Sollinger1

  • 1Division of Nephrology, I. Department of Medicine, University Medical Center, Mainz, Germany.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|August 28, 2019
PubMed

Antibodies against THSD7A (thrombospondin type 1 domain-containing protein 7A) have been proposed to play a causal role in the development of nephrotic syndrome in patients with THSD7A antibody-positive membranous nephropathy. We hypothesized that removal of these antibodies from plasma could lead to a rapid reduction in proteinuria. Using immunoadsorption to reduce THSD7A antibodies led to a rapid reduction in proteinuria in 2 patients with THSD7A antibody-positive membranous nephropathy. Moreover, our findings support and strengthen the pathogenic role of the antibodies in the development of nephrotic syndrome in patients with THSD7A antibody-positive membranous nephropathy. Taken together, these 2 cases suggest that immunoadsorption could be a useful tool in the treatment of patients with THSD7A antibody-positive membranous nephropathy.

Keywords:
THSD7A (thrombospondin type 1 domain-containing protein 7A)autoantibodiescase reportimmunoadsorptionkidney biopsymalignancy-associated MNmembranous nephropathy (MN)nephrotic syndrome (NS)proteinuriaurinary protein-creatinine ratio (UPCR)

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