ArticleJournal of the American Society of Nephrology : JASN2012
Recurrent membranous nephropathy in an allograft caused by IgG3κ targeting the PLA2 receptor.
Article in Journal of the American Society of Nephrology : JASN, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 1 of them a synthesis that pooled it.
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Who cites it
45 citing papers in PubMed, 1 synthesis or guideline pooled it, 107 citations in OpenAlex.
- The evaluation of monoclonal gammopathy of renal significance: a consensus report of the International Kidney and Monoclonal Gammopathy Research Group.Nature reviews. Nephrology · 2019Guideline
- Monoclonal gammopathy of clinical significance: a multisystem review.Blood cancer journal · 2026Review
- Recurrent, Nonrecurrent, and De Novo Membranous Nephropathy After Kidney Transplantation: A Systematic Review and Meta-Analysis.Kidney medicine · 2026Article
- Clinical and Pathological Characteristics of Non-AL Amyloidosis MGRS: A Single-Center Experience Over 10 Years.Canadian journal of kidney health and disease · 2025Article
- Renal manifestations of MGUS.Hematology. American Society of Hematology. Education Program · 2024Review
- Monoclonal gammopathy of renal significance from the perspective of nephrologists.Blood research · 2024Review
- Membranous nephropathy after multiple Hymenoptera stings: a case report.CEN case reports · 2024Article
- The Prevalence, Characteristics, and Putative Mechanisms of Dual Antigen-Positive Membranous Nephropathy: The Underestimated Condition.International journal of molecular sciences · 2024Review
- Unraveling monoclonal gammopathy of renal significance: a mini review on kidney complications and clinical insights.Frontiers in nephrology · 2024Review
- High exposure to tacrolimus is associated with spontaneous remission of recurrent membranous nephropathy after kidney transplantation.Clinical kidney journal · 2023Article
- First case report of PLA2R-related monotypic (IgG-κ positive) membranous nephropathy concurrent with leukocyte chemotactic factor 2 amyloidosis.BMC nephrology · 2023Article
- Relapse of Monoclonal Gammopathy of Renal Significance after mRNA COVID-19 Vaccination: A Case Report.Life (Basel, Switzerland) · 2023Article
- Lectin Complement Pathway Activation is Associated with Massive Proteinuria in PLA2R-Positive Membranous Nephropathy: A Retrospective Study.International journal of general medicine · 2023Article
- B7-1 mediates podocyte injury and glomerulosclerosis through communication with Hsp90ab1-LRP5-β-catenin pathway.Cell death and differentiation · 2022Article
- Mechanisms of Primary Membranous Nephropathy.Biomolecules · 2021Review
- Analysis of Glomerular IgG Subclasses Switch in Idiopathic Membranous Nephropathy Classified by Glomerular Phospholipase A2 Receptor Antigen and Serum Antibody.Disease markers · 2021Article
- Detection of PLA2R Autoantibodies before the Diagnosis of Membranous Nephropathy.Journal of the American Society of Nephrology : JASN · 2020Article
- Deposition of the Membrane Attack Complex in Healthy and Diseased Human Kidneys.Frontiers in immunology · 2020Review
- Plasma exchange and rituximab treatments in primary membranous nephropathy combined with crescentic glomerulonephritis: A case report.Medicine · 2019Article
- Membranous Nephropathy (MN) Recurrence After Renal Transplantation.Frontiers in immunology · 2019Review
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9 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Up to 80% of patients with idiopathic membranous nephropathy have non-complement-fixing IgG4 autoantibodies to the phospholipase A2 receptor (PLA2R). Membranous nephropathy recurs in approximately 40% of patients after kidney transplantation, but the mechanism is unknown. Here, we describe a patient with recurrent membranous nephropathy 13 days after kidney transplantation whose graft biopsy specimen showed granular staining for C3, C5b-9, C1q, and IgG3κ; electron microscopy revealed subepithelial nonorganized deposits. A search for hematologic disorders was negative. Retrospective evaluation of a biopsy sample from the native kidney revealed a similar pattern: monotypic IgG3κ deposits together with C3, C1q, and C5b-9. Glomerular deposits contained PLA2R in both the graft and the native kidney, suggesting that the recurrence was the result of circulating anti-PLA2R antibodies binding to PLA2R antigen expressed on donor podocytes. Confocal analysis of anti-PLA2R and antihuman IgG3 showed co-localization, and the patient had IgG3κ-restricted circulating anti-PLA2R antibodies. Treatment with rituximab stabilized both proteinuria and serum creatinine, and circulating anti-PLA2R became undetectable. In summary, this case of recurrent membranous nephropathy in a graft suggests that circulating monoclonal anti-PLA2R IgG3κ caused the disease and activated complement by the classic pathway.
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