ArticleFrontiers in medicine2025
Clinical and pathological characteristics of NELL-1-positive membranous nephropathy: a case series study.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- A Clinicopathologic Study of Neural Epidermal Growth Factor-Like 1-Associated Membranous Nephropathy in a Chinese Cohort.Kidney international reports · 2026Article
- Multicentre comparative study of neural epidermal growth factor-like 1 proteinWorld journal of nephrology · 2026Article
- Contemporary review of primary membranous nephropathy.Frontiers in immunology · 2026Review
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4 authors.
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Abstract
Objective: This study aimed to comprehensively characterize the clinical and pathological features, treatment strategies, and outcomes of patients with neural epidermal growth factor-like 1 protein (NELL-1)-positive membranous nephropathy (MN). Methods: We retrospectively analyzed non-systemic lupus erythematosus (SLE) MN patients diagnosed between January 2010 and August 2021 at Cangzhou Central Hospital, China. Inclusion required negative PLA2R and THSD7A staining and available paraffin-embedded renal tissue. Clinical, laboratory, pathological, treatment, and outcome data were collected and analyzed descriptively. Results: Among 531 non-SLE MN cases screened, 23 patients (13 males, 10 females; mean age 49.4 ± 12.0 years) were identified as NELL-1(+), PLA2R(-), and THSD7A(-). Hypertension was present in 26.1%, and nephrotic syndrome in 60.9% of patients. Bright granular NELL-1 deposits along glomerular capillary loops were observed in all cases, with segmental or incomplete global distribution seen in 65.2%. IgG4 and IgG1 were the predominant immunoglobulin subclasses (82.6 and 78.2%, respectively). Over a median follow-up of 56 months, 73.9% received immunosuppressive therapy, while 26.1% were managed with supportive treatment alone. The overall remission rate was 87.0% (73.9% complete, 13.0% partial), with only two patients experiencing transient renal function decline and none progressing to end-stage renal disease. Notably, 26.1% of patients developed malignancies, most commonly lung cancer. In patients with malignancy, tumor resection and supportive therapy alone frequently led to remission of MN. Conclusion: NELL-1-positive MN is characterized by high rates of IgG1 and IgG4 deposition and generally favorable responses to therapy. A substantial proportion of patients were diagnosed with malignancy, highlighting the importance of cancer screening in this population. Timely identification and management of underlying malignancy may contribute to improved renal outcomes.
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