Approximately half of lupus patients have kidney disease, including membranous glomerulopathy. 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. It is important to determine an antigen in these cases, as it can be linked to patient prognosis. The most common antigen seen in membranous lupus nephritis is EXT1/2, followed by NCAM1. This study identified a new target antigen, TGFBR3, seen in approximately 6% of membranous lupus nephritis cases. TGFBR3 was also seen in a few patients with membranous glomerulopathy and other autoimmune diseases. Of 15 patients who were followed clinically, only 2 achieved clinical remission (average 11-month follow-up). Patients with TGFBR3 positive membranous glomerulopathy should undergo a workup for autoimmune disease.
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