Assay of circulating antibodies against the phospholipase A2 receptor (PLA2R) is used in the workup of primary membranous nephropathy. Which statement about this test is correct?
- A Rising PLA2R antibody titers predict spontaneous remission
- B PLA2R antibodies are detectable in nearly all cases of hepatitis B associated membranous nephropathy
- C PLA2R antibodies are present in about 70 percent of patients with primary membranous nephropathy and are usually absent in secondary forms ✓
- D PLA2R is expressed on the endothelial aspect of the glomerular basement membrane
Correct answer: C. PLA2R antibodies are present in about 70 percent of patients with primary membranous nephropathy and are usually absent in secondary forms
Explanation
PLA2R is a transmembrane glycoprotein on the podocyte foot process, and anti-PLA2R antibodies are found in roughly 70 to 80 percent of primary (idiopathic) membranous nephropathy while being characteristically absent in secondary cases linked to HBV, malignancy or drugs, making the test useful for distinguishing primary from secondary disease. Titers track disease activity, so rising titers indicate relapse rather than remission.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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