NELL-1 Associated Membranous Nephropathy - A Case Series from India

Neural epidermal growth factor-like 1 (NELL-1) is responsible for a substantial proportion of cases of PLA2R-negative primary membranous nephropathy (MN). To investigate the occurrence, association, and treatment responses, we carried out this ambispective study. In the study, nine (10%) of all patients with MN at our center were found to be NELL-1 positive. On follow up, all patients recieved immunosuppression (steroids, cyclophosphamide or rituximab). Five patients were in complete remission, while one patient had partial remission, two patients had a progressive decline in kidney function, and one patient was lost to follow-up early. No link was found with malignancies, traditional Indian medicines or infection.