title: Retrospective Study of Phospholipase A2 Receptor and IgG Subclasses in Glomerular Deposits in Chinese Patients with Membranous Nephropathy.
abstract: OBJECTIVE
  The research work in the past years showed that detection of phospholipase A2 receptor (PLA2R) antigen and its dominant IgG4 autoantibody in glomerular deposits of patients with membranous nephropathy (MN) was useful for the differentiation between primary MN (PMN) and secondary MN (SMN), but so far such research data from large Chinese patient series is little. Here, we are going to report a research work in a Chinese cohort.
  
  
  METHODS
  This study enrolled 179 patients with PMN, 40 patients with membranous lupus nephritis (LN-MN), 26 patients with hepatitis B virus-associated MN (HBV-MN), 2 patients with malignancy-associated MN (M-MN) and one patient with IgG4-related MN (IgG4-MN). PLA2R and IgG subclasses in glomerular deposits of these patients were examined by immunofluorescence and/or immunohistochemical staining, and the potential value of the above examinations for differential diagnosis of PMN and SMN was evaluated.
  
  
  RESULTS
  Glomerular PLA2R deposition was present in 92.2% patients with PMN and 7.7% patients with HBV-MN, but none of the patients with LN-MN. Predominant/codominant IgG4 deposition was found in 93.3% patients with PMN and 11.5% patients with HBV-MN, but none of the patients with LN-MN. The two M-MN patients both had glomerular PLA2R and predominant/codominant IgG4 deposition. The one IgG4-MN patient had deeply staining IgG4 but no PLA2R in glomeruli.
  
  
  CONCLUSIONS
  The glomerular PLA2R and predominant/codominant IgG4 deposition is frequently observed in Chinese patients with PMN. Immunofluorescence and immunohistochemical staining of renal biopsy tissue for detection of glomerular PLA2R and IgG subclasses deposition can help to distinguish PMN from LN-MN and most of HBV-MN.
authors.affiliation: Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Hong-Rui
authors.initials: HR
authors.lastname: Dong
authors.affiliation: Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Yan-Yan
authors.initials: YY
authors.lastname: Wang
authors.affiliation: Division of Nephrology, Shanxi Traditional Chinese Medicine Hospital, Xian, P.R. China.
authors.forename: Xiao-Hong
authors.initials: XH
authors.lastname: Cheng
authors.affiliation: Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Guo-Qing
authors.initials: GQ
authors.lastname: Wang
authors.affiliation: Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Li-Jun
authors.initials: LJ
authors.lastname: Sun
authors.affiliation: Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Hong
authors.initials: H
authors.lastname: Cheng
authors.affiliation: Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Yi-Pu
authors.initials: YP
authors.lastname: Chen
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000378:metabolism; D002681:China; D003937:Diagnosis, Differential; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000209:etiology / Q000276:immunology / Q000473:pathology*; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism*; D007678:Kidney Glomerulus / Q000378:metabolism / Q000473:pathology; D008181:Lupus Nephritis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D054507:Receptors, Phospholipase A2 / Q000276:immunology / Q000378:metabolism*; D012189:Retrospective Studies
chemical_list: D001323:Autoantibodies; D007074:Immunoglobulin G; D054507:Receptors, Phospholipase A2