An immunofluorescence test for phospholipase-A₂-receptor antibodies and its clinical usefulness in patients with membranous glomerulonephritis

Nephrol Dial Transplant. 2011 Aug;26(8):2526-32. doi: 10.1093/ndt/gfr247. Epub 2011 Jun 1.


Background: The recent finding that phospholipase-A(2)-receptor antibodies (PLA(2)R-AB) may play a role in the development of primary membranous glomerulonephritis (MGN) offers the opportunity to measure a marker to help diagnose, classify and eventually monitor the course of patients with MGN.

Methods: We developed an immunofluorescence test, which allows the easy and specific analysis of the presence of PLA(2)R-AB in serum. The usefulness of this test was studied in 153 healthy blood donors, 90 patients with non-membranous glomerular injuries, 17 patients with a secondary form of MGN and 100 patients with biopsy-proven primary MGN. In addition, in five patients with biopsy-proven MGN, PLA(2)R-AB levels were monitored prospectively for up to 18 months following a single dose of rituximab (RTX) (375 mg/m(2) body surface).

Results: PLA(2)R-AB were not found in healthy controls or patients with glomerular lesions other than biopsy-proven primary MGN. Fifty-two patients with primary MGN (52%) were positive for PLA(2)R-AB. The levels ranged from 1:10 to 1:3200. In patients who had MGN and were treated with RTX the fall in PLA(2)R-AB levels was followed by a decrease in proteinuria, whereas an increase in PLA(2)R-AB levels was associated with an increase in proteinuria.

Conclusions: These studies show that the new test allows the monitoring of PLA(2)R-AB levels in patients with MGN and may help in making therapeutic decisions for these patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies / blood*
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Case-Control Studies
  • Fluorescent Antibody Technique
  • Glomerulonephritis, Membranous / complications
  • Glomerulonephritis, Membranous / diagnosis*
  • Glomerulonephritis, Membranous / drug therapy
  • Humans
  • Immunoblotting
  • Kidney Glomerulus / metabolism
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Proteinuria / diagnosis*
  • Proteinuria / drug therapy
  • Proteinuria / etiology
  • Receptors, Phospholipase A2 / antagonists & inhibitors
  • Receptors, Phospholipase A2 / immunology*
  • Rituximab


  • Antibodies
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents
  • Receptors, Phospholipase A2
  • Rituximab