Thromboembolic complication is associated with patients with hypoalbuminaemia and will be one of the factors to consider for prophylactic anticoagulation in patients with IMN. RAMACHANDRAN RAJA1, SHARMA VINOD4, VERMA ASHWINI3, NADA RITAMBHRA2, JHA VIVEKANAND5, GUPTA KRISHAN LAL5 1Assistant Professor, Dept of Nephrology, PGIMER; 2Additional Professor, Dept of Histopathology, PGIMER; 3PhD scholar, Dept of Histopathology, Selinexor research buy PGIMER; 4PhD scholar, Dept of Nephrology, PGIMER; 5Professor,
Dept of Nephrology, PGIMER Introduction: M-type phospholipase A2 receptor (PLA2R) was recently identified as a major target antigen involved in IMGN in adults. Anti PLA2R antibodies are found in 57–70% of patients with IMGN. Renal biopsy tissue staining for PLA2R antigen was found in 69–74% of IMGN patients. Aim of the study is to access the incidence of PLA2R antibody in serum and PLA2R in glomerular immune deposits in patients with nephrotic syndrome and biopsy proved IMGN. Methods: The study was carried at NehruHospital, PGIMER, Chandigarh from Sep 2011 to Jan 2013. Adult patients (18–70 yrs) with nephrotic syndrome (24 hr urine protein >3.5 gm/day or 24 hr urine protein ≥1.5 gm/day with a serum albumin of 2R were collected at the time of biopsy and tested by ELISA. Serum from healthy control were use to define the normal range. PLA2R in immune deposits was assessed by confocal microscopy in paraffin blocks with affinity-purified
specific anti-PLA2R antibodies. Patients who had persistent of nephrotic syndrome at 6 months of therapy the serum samples were analysed beta-catenin mutation for anti PLA2R antibodies. Results: The study included 36 (M/F 22/14) patients with nephrotic syndrome. The mean age at presentation was 41.4 ± 13.9 (18–70) yrs. The mean duration of nephrotic syndrome ranged from 2–8 months. The baseline 24 hr urine protein, sr albumin and sr creatinine aminophylline was 5.4 ± 3.6 (range 1.5–19) gm, 2.08 ± 0.42 (1–2.9) gm/dl and 0.84 ± 0.26 (0.32–1.8) mg/dl respectively. Thirty (83.3%) patients had PLA2R in the glomerular immune deposits. Twenty-one (58.3%) patients tested positive for anti PLA2R antibodies in the serum. Six patients had refractory nephrotic syndrome at 6 months of therapy.
Out of these 6 patients 3 had positive anti PLA2R antibodies at baseline, anti PLA2R antibodies persisted in all 3 patients at 6 months. None of the patients with class V lupus nephritis (n = 8) had either PLA2R in glomerular deposits or anti PLA2R antibodies in serum. Conclusion: PLA2R in glomerular deposits and anti PLA2R antibodies in serum is seen in majority of Indian patients with active IMGN. DISSAYABUTRA THASINAS1, RATTANAPHAN JAKKAPHAN1, KALPONGNUKUL NUTTIYA1, BOONLA CHANCHAI1, UNGCHAREONWATTANA WATTANACHAI2, TOSUKHOWONG PIYARATANA1 1Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 2Department of Surgery, Sunpasitprasong Hospital, Ubon Ratchathani, Thailand Introduction: Nephrolithiasis is a common urologic disease in Southeast Asia.