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NELL1 Is A Target Antigen In Malignancy-Associated Membranous Nephropathy

By Dr. Rebecca May

Dec 22, 2021

Membranous nephropathy is a leading cause of nephrotic syndrome. On renal biopsy, immunofluorescence shows granular capillary loop deposits, and holes are seen in the capillary loops on silver stain. Electron microscopy shows subepithelial immune complex deposits. A majority of cases have autoantibodies against PLA2R and THSD7A. This study identified a new target antigen, NELL1, which was present in 1.7% of membranous cases. NELL1 can also be detected in the serum of these patients. Approximately 33% of patients with NELL1 have a known malignancy. Patients with successful treatment of the malignancy showed good responses to membranous treatment. Patients with NELL1 positive membranous nephropathy should receive age-appropriate cancer screening.



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