Evidence map›Paper›PMID 42022276›Full record

ArticleClinical kidney journal2026

Protocadherin FAT1-associated membranous nephropathy after hematopoietic stem cell transplantation-a cohort study with clinico-pathological correlations.

Maja C Nackenhorst, Daniela Milovanovic, Alice Schmidt, Nicola Mongera, Maximilian Köller, Werner Passler, Daniel Cejka, Nicolas Kozakowski

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Article in Clinical kidney journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Maja C NackenhorstDepartment of Pathology, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0000-0002-1591-0483
Daniela MilovanovicDepartment of Pathology, Medical University of Vienna, Vienna, Austria.
Alice SchmidtDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Nicola MongeraNephrology Department, Bolzano Hospital, Italy.
Maximilian KöllerDepartment of Pathology, Medical University of Vienna, Vienna, Austria.
Werner PasslerNephrology Department, Bolzano Hospital, Italy.
Daniel CejkaDepartment of Nephrology, Hypertension, Transplant Medicine, Rheumatology, Geriatrics, Ordensklinikum Linz Elisabethinen, Linz, Austria.
Nicolas KozakowskiDepartment of Pathology, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0000-0001-9180-620X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The identification of causative antigens for membranous nephropathy (MN) has revolutionized the comprehension of the pathophysiology of this autoimmune disease and its management. Recently, some studies described protocadherin FAT1 (FAT1) as a causal antigen in the context of hematopoietic stem cell transplantation (HSCT). The aim of this study was to investigate the large Viennese kidney biopsy collection at the Department of Pathology of the Medical University of Vienna and explore MN cases after HSCT for the causative antigen. Methods: Fifteen patients were identified with MN in diagnostic renal biopsies for proteinuria/nephrotic syndrome after HSCT between 2001 and 2024. Cases were reviewed and tested for the expression of FAT1 by immunofluorescence specifically. Results: Immunofluorescence showed that 12 out of 15 patients with MN had FAT1 expression, appearing 2.3 years after HSCT. In three patients without FAT1 expression, MN appeared 3.8 years after HSCT, with one testing positive for phospholipase A2 receptor (PLA2R) and two with unknown antigens. Serum creatinine for FAT1+ MN was 1.2 mg/dl, while FAT1- MN was 1.3 mg/dl. Proteinuria was 8 g/g compared to 10.4 g/g, respectively. IgG4 positivity was seen in 30% of FAT1+ MN cases. Over a follow up of 5.2 years, of the seven FAT1+ MN patients treated with rituximab, four achieved complete remission, two partial remission, and one was non-responsive. Conclusion: This hitherto largest single-center-cohort solidifies FAT1 as a causative antigen for MN in the setting of HSCT. However, not all post-HSCT-MN are related to FAT1.

Indexed as

FAT atypical cadherin 1formalin-fixedhematopoietic stem cell transplantationimmunofluorescencemembranous nephropathyparaffin-embedded

Identifiers

PMID42022276
PMCPMC13098137

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