Diagnostic value of serum anti-phospholipase A2 receptor antibodies (PLA2R) in idiopathic membranous nephropathy
10.3760/cma.j.issn.1009-9158.2015.09.007
- VernacularTitle:磷脂酶 A2受体抗体在特发性膜性肾病中的诊断价值
- Author:
Guanghua NIU
;
Yujie GAO
;
Baishan WANG
;
Lina WU
;
Hongyang GUO
;
Baihui CUI
;
Cheng ZHANG
;
He GUO
- Publication Type:Journal Article
- Keywords:
Glomerulonephritis,membranous;
Receptors,phospholipase A2;
Autoantibodies;
Fluorescent antibody technique,indirect
- From:
Chinese Journal of Laboratory Medicine
2015;(9):595-599
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnostic value and monitoring application of anti-phospholipase A2 receptor antibodies ( PLA2R ) in patients with idiopathic membranous nephropathy ( IMN) .Methods A retrospective study was used .48 patients were diagnosed as idiopathic membranous nephropathy by puncturing kidney from January of 2013 to June of 2014 in the Hospital of Liaoning Traditional Chinese Medical University and Shengjing Hospital of China Medical University were included. 43 patients were diagnosed as non-idiopathic membranous nephropathy ( NIMN ).35 healthy volunteers were selected as control groups.Serum PLA2R were detected by indirect immunofluorescence.The intensity of antibodies fluorescence and the level of urine protein in 24 hours(24 h PRO) ,serum UREA ,serum CYSC, serum UA,GFR were compared in each groups.Measurement data was shown as mean ±standard deviation;Count data was shown as frequency or composition, t test andχ2 test were used as statistical method.Results (1) Among 48 cases with IMN,37 cases showed positive PLA2R (positive rate 77.08%).All of cases were negative in NIMN group.The sensitivity and the specificity of serum PLA2R were 77.08%and 100%.(2) Compared with control groups, the levels of UREA, CYSC and UA were found statistically significant differences in patients with IMN ( P <0.05 ) .( The levels of UREA in control groups and IMN groups respectively:4.12 ±1.25,6.02 ±2.28, t =4.446,P=0.00;UA:262 ±49,331 ±112,t =2.577,P =0.017;CYSC:0.78 ±0.21,1.16 ±0.27,t=4.63,P=0.00.) Compared with control groups, the levels of main items in patients with NIMN had statistically significant differences (P<0.05).(The levels of UREA in control groups and Allergic purpura nephropathy subgroups respectively:4.12 ±1.25,5.43 ±1.84,t=3.606,P=0.000 2;UA:262 ±49, 299 ±51, t=1.050,P=0.03;CYSC:0.78 ±0.21, 1.06 ±0.31, t=1.672,P=0.02.The levels of UREA in control groups and lupus nephropathy subgroups respectively:4.12 ±1.25, 5.90 ±2.20,t=4.225,P=0.00;UA:262 ±49, 342 ±92,t=2.409,P=0.026;CYSC:0.78 ± 0.21,0.92 ±0.24, t =1.674, P =0.00.The levels of UREA in control groups and IgA nephropathy subgroups respectively:4.12 ±1.25,6.69 ±2.87,t=4.756,P=0.00;UA:262 ±49,361 ±52,t=4.598, P=0.00;CYSC:0.78 ±0.21, 1.30 ±0.36,t=4.752,P=0.00.The levels of UREA in control groups and tumor associated nephropathy subgroups respectively: 4.12 ±1.25, 5.02 ±1.70, t =3.626, P =0.002;UA:262 ±49, 289 ±92,t=0.05,P=0.01;CYSC:0.78 ±0.21, 0.98 ±0.20,t=1.1,P=0.01.) There was no statistically significant differences between IMN group and NIMN ( P >0.05 ) . ( 3 ) Positive correlation were found between 24 h PRO(r=0.877,P=0.00),serum UA (r=0.766,P=0.00 ) with the level of PLA2R antibodies fluorescence intensity.( 4 ) There were no correlation between serum PLA2R antibody with IMN pathology aging (r=0.087,0.194,0.182;P=0.598,0.399,0.667).PLA2R positive rate(Ⅰstage:37.50%,Ⅱstage:84.85%, Ⅲstage 85.71%) may increases with the increasing of illness severity.Conclusion Serum PLA2R antibody would be a new laboratory diagnosis standard in patients with IMN.(Chin J Lab Med, 2015, 38:595-599 ) Objective To investigate the diagnostic value and monitoring application of anti-phospholipase A2 receptor antibodies ( PLA2R ) in patients with idiopathic membranous nephropathy ( IMN) .Methods A retrospective study was used .48 patients were diagnosed as idiopathic membranous nephropathy by puncturing kidney from January of 2013 to June of 2014 in the Hospital of Liaoning Traditional Chinese Medical University and Shengjing Hospital of China Medical University were included. 43 patients were diagnosed as non-idiopathic membranous nephropathy ( NIMN ).35 healthy volunteers were selected as control groups.Serum PLA2R were detected by indirect immunofluorescence.The intensity of antibodies fluorescence and the level of urine protein in 24 hours(24 h PRO) ,serum UREA ,serum CYSC, serum UA,GFR were compared in each groups.Measurement data was shown as mean ±standard deviation;Count data was shown as frequency or composition, t test andχ2 test were used as statistical method.Results (1) Among 48 cases with IMN,37 cases showed positive PLA2R (positive rate 77.08%).All of cases were negative in NIMN group.The sensitivity and the specificity of serum PLA2R were 77.08%and 100%.(2) Compared with control groups, the levels of UREA, CYSC and UA were found statistically significant differences in patients with IMN ( P <0.05 ) .( The levels of UREA in control groups and IMN groups respectively:4.12 ±1.25,6.02 ±2.28, t =4.446,P=0.00;UA:262 ±49,331 ±112,t =2.577,P =0.017;CYSC:0.78 ±0.21,1.16 ±0.27,t=4.63,P=0.00.) Compared with control groups, the levels of main items in patients with NIMN had statistically significant differences (P<0.05).(The levels of UREA in control groups and Allergic purpura nephropathy subgroups respectively:4.12 ±1.25,5.43 ±1.84,t=3.606,P=0.000 2;UA:262 ±49, 299 ±51, t=1.050,P=0.03;CYSC:0.78 ±0.21, 1.06 ±0.31, t=1.672,P=0.02.The levels of UREA in control groups and lupus nephropathy subgroups respectively:4.12 ±1.25, 5.90 ±2.20,t=4.225,P=0.00;UA:262 ±49, 342 ±92,t=2.409,P=0.026;CYSC:0.78 ± 0.21,0.92 ±0.24, t =1.674, P =0.00.The levels of UREA in control groups and IgA nephropathy subgroups respectively:4.12 ±1.25,6.69 ±2.87,t=4.756,P=0.00;UA:262 ±49,361 ±52,t=4.598, P=0.00;CYSC:0.78 ±0.21, 1.30 ±0.36,t=4.752,P=0.00.The levels of UREA in control groups and tumor associated nephropathy subgroups respectively: 4.12 ±1.25, 5.02 ±1.70, t =3.626, P =0.002;UA:262 ±49, 289 ±92,t=0.05,P=0.01;CYSC:0.78 ±0.21, 0.98 ±0.20,t=1.1,P=0.01.) There was no statistically significant differences between IMN group and NIMN ( P >0.05 ) . ( 3 ) Positive correlation were found between 24 h PRO(r=0.877,P=0.00),serum UA (r=0.766,P=0.00 ) with the level of PLA2R antibodies fluorescence intensity.( 4 ) There were no correlation between serum PLA2R antibody with IMN pathology aging (r=0.087,0.194,0.182;P=0.598,0.399,0.667).PLA2R positive rate(Ⅰstage:37.50%,Ⅱstage:84.85%, Ⅲstage 85.71%) may increases with the increasing of illness severity.Conclusion Serum PLA2R antibody would be a new laboratory diagnosis standard in patients with IMN.
