ArticleJournal of nephrology2018
Routine immunohistochemical staining in membranous nephropathy: in situ detection of phospholipase A2 receptor and thrombospondin type 1 containing 7A domain.
Article in Journal of nephrology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Diagnostic performance and inter-observer reproducibility of glomerular PLA2R immunohistochemistry in primary membranous nephropathy: a multi-laboratory blinded observer study.BMC nephrology · 2026Article
- Benchmarking digital displays (monitors) for histological diagnoses: the nephropathology use case.Journal of clinical pathology · 2025Article
- Clinicopathological and prognostic characteristics of idiopathic membranous nephropathy with dual antigen positivity.Frontiers in immunology · 2023Article
- A cohort study of membranous nephropathy, primary or secondary.BMC nephrology · 2021Article
- Identical twins with idiopathic membranous nephropathy.Journal of nephrology · 2021Article
- Diagnostic performance of glomerular PLA2R and THSD7A antibodies in biopsy confirmed primary membranous nephropathy in South Africans.BMC nephrology · 2021Article
- Circulating antibodies against M-type phospholipase A2 receptor and thrombospondin type-1 domain-containing 7A in Chinese patients with membranous nephropathy.International urology and nephrology · 2019Article
- Clinical significance of C4d deposition in renal tissues from patients with primary Sjögren's syndrome-a preliminary study.BMC nephrology · 2019Article
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8 authors.
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Abstract
backgroundMembranous nephropathy (MN) can be idiopathic (iMN) or manifest as a result of systemic underlying conditions as a secondary epiphenomenon. For the prognostic and predictive consequences of this discrimination, the routine use of reliable markers is crucial. This large MN series aimed to evaluate the routine and standardized immunohistochemical (IHC) employment of a panel of 3 biomarkers-phospholipase A2 receptor (PLA2R), thrombospondin type-1 domain-containing 7A (THSD7A), and immunoglobulin (Ig)G4-in the differential diagnosis of MN forms, contributing to the validation of the technique and the correct interpretation of reproducible patterns of reactivity.
methodsWe classified 95 patients with a biopsy proven diagnosis of MN as primary (n = 72) or secondary (n = 23) cases based on clinical data. After performing an IHC assay directed against PLA2R, THSD7A and IgG4 antigens, samples were interpreted by three different nephropathologists to assess the positivity/negativity of the staining according to new interpretation criteria.
resultsUseful interpretation criteria were introduced to exclude false positive patterns of reactivity and to identify only true granular membranous or mesangial deposits in MN. The IHC directed against PLA2R resulted positive in 51 iMN cases and negative in 21, while 4/23 secondary forms were considered positive. Based on these data the technique showed a sensitivity of 71% and specificity of 83%. On the other hand, the IHC analysis for IgG4 resulted positive in 44 cases of iMN and negative in 28 cases, while only 4/23 secondary forms were positive (same cases positive to PLA2R). Finally, THSD7A was found to be positive only in 1 case, which was negative to PLA2R and IgG4. The combination of the results allowed a classification of the series into two major groups: "double-positive" (PLA2R+/IgG4+/THSD7A-) and "triple-negative" (PLA2R-/IgG4-/THSD7A-) cases.
conclusionsBased on these data, the diagnostic performance of the three biomarkers used in a "tandem fashion" can reach 79% sensitivity and 83% specificity, significantly reducing the risk of a false-positive or false-negative result and improving the routine characterization of this frequent glomerulonephritis.
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