الفهرس 
ROLE OF BIOMARKERS IN DIAGNOSIS OF NEPHROTIC SYNDROMEOnly 14 pages are availabe for public view
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Abstract
M
embranous nephropathy (MN) is among the most common causes of the nephrotic syndrome in nondiabetic adults, accounting for approximately 20 to 30 percent of cases of nephrotic syndrome in White adults.
MN is most often primary (previously called idiopathic), although it may be secondary with hepatitis B infection, autoimmune diseases as systemic lupus erythematosus (SLE), malignancies, and the use of certain drugs such as nonsteroidal antiinflammatory drugs (NSAIDs). MN in young females should raise the suspicion of SLE.
The M-type PLA2R, a transmembrane receptor that is highly expressed in glomerular podocytes, has been identified as a major antigen in primary MN.
Anti-PLA2R antibodies have been identified in approximately 70 to 80 percent of patients with primary MN.
A relatively low sensitivity of circulating anti-PLA2R antibodies than detection of PLA2R antigen within immune deposits by immunofluorescence of the biopsy specimen had been reported in previous studies.
The aim of this cross-sectional study is to show the prevalence of anti-PLA2R antibodies in Egyptian patients with biopsy proven membranous nephropathy.
Our cross-sectional study included 70 Egyptian patients with nephrotic range proteinuria on first presentation for whom laboratory investigations including serum anti-PLA2R antibodies titer by indirect immunoflouresence and kidney biopsy were done.
Statistical analysis of our results revealed the following findings:
Membranous nephropathy has been diagnosed in 35.71% of adult Egyptian patients presented with nephrotic range proteinuria.
84% of the cases of membranous nephropathy had been diagnosed with primary membranous nephropathy and 16% diagnosed with secondary membranous nephropathy.
Sensitivity of circulating anti-PLA2R antibodies in primary MN was 42.85% versus 80.95% for its detection within the glomerular extracts.
Specificity of PLA2R is close to 100%; however, in other studies; PLA2R has been detected in the immune deposits of some patients with secondary MN.
Patients with high anti-PLA2R titer had higher baseline proteinuria than patients with lower anti-PLA2R titer.