EXT1 And NCAM1-Associated Membranous Lupus Nephritis In A Cohort Of Patients Undergoing Repeat Kidney Biopsies

Systemic lupus erythematosus (SLE) is an autoimmune disease in which approximately 50% of patients have kidney involvement (lupus nephritis). Membranous glomerulopathy makes up a subset of lupus nephritis. On renal biopsy, immunofluorescence shows granular capillary loop deposits. Electron microscopy shows subepithelial immune complex deposits. EXT1/2 and NCAM1 are two antigens which have been shown to be present in membranous lupus nephritis. This study looked at EXT1 and NCAM1 glomerular staining over time in patients with multiple renal biopsies. A total of 31 patients with multiple biopsies were studied. EXT1 positive patients had lower levels of chronicity compared to EXT1 negative patients at diagnosis, but both groups showed a similar rate of decline in kidney function over time. EXT1 staining can be dynamic, as a proportion of patients lost or gained expression of EXT1 in subsequent biopsies.

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