Diagnostic performance of glomerular PLA2R and THSD7A antibodies in biopsy confirmed primary membranous nephropathy in South Africans

BMC Nephrology

卷:22

Ugochi S Okpechi-Samuel¹  Aminu K Bello²  Udeme E Ekrikpo³  Pierre Ronco⁴  Ikechi G. Okpechi⁵  Nicola Wearne⁵  Bingileki F Lwezaula⁵  Oluwatoyin I Ameh⁶  Francois CJ Botha⁷ 

[1] Department of Internal Medicine, Federal Medical Centre;

[2] Department of Medicine, University of Alberta;

[3] Department of Medicine, University of Uyo;

[4] Department of Nephrology and Dialysis, Assistance Publique-Hôpitaux de Paris, Tenon Hospital;

[5] Division of Nephrology and hypertension, University of Cape Town;

[6] Division of Nephrology, Zenith Medical & Kidney Centre;

[7] Pathcare Laboratories;

关键词: Africans;    Primary membranous nephropathy;    Lupus nephritis;    PLA2R;    THSD7A;   

DOI  :  10.1186/s12882-020-02216-7

来源: DOAJ

【 摘 要 】

Abstract Background: Serum and tissue-based tests using phospholipase A2 receptor 1 (PLA2R) and thrombospondin type-1 domain containing 7A (THSD7A) are established immune biomarkers for the diagnosis of primary membranous nephropathy (PMN). This study assessed the diagnostic performance of these biomarkers in the diagnosis of PMN in South Africans. Methods This was a cross-sectional analysis from a single centre in Cape Town, South Africa. Relevant biodata was collected from all patients. Histology, including slides for PLA2R and THSD7A were processed and assessed by typical microscopic and immunohistochemical features. Biopsy tissues of patients with membranous lupus nephritis (LN-V) and diabetic nephropathy (DN) were used as controls. The diagnostic accuracy for diagnosis of PMN using positive PLA2R and THSD7A were evaluated. Results Of the 88 patients included, 41 had PMN with a mean age of 44.5 ± 17.5 years and 61.0% were female. Histologically, PLA2R and THSD7A were only positive in the PMN group (51.2% and 4.9%, respectively) but negative in both control groups. The sensitivity of PLA2R and THSD7A for identifying PMN was 51.2% and 4.9%, respectively. The sensitivity of both tests together was 53.7% while the specificity and positive predictive values (PPV) for any of the tests (alone or in combination) was 100%. There was no difference in the sensitivity and specificity when using PLA2R alone compared to combining the two tests (p=0.32). Conclusion Glomerular staining of PLA2R and THSD7A could have potential diagnostic values in South Africans. This has implications on how immunotherapies can be initiated and used in these settings.

【 授权许可】

Unknown