Tissue PLA2R Membranous — ESENeph MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: C — Tissue PLA2R supports PLA2R-associated membranous nephropathy despite borderline serum testing
The best answer is “Tissue PLA2R supports PLA2R-associated membranous nephropathy despite borderline serum testing”. Serology varies with disease phase and treatment. Tissue staining, biopsy pattern and clinical secondary-cause assessment are interpreted together. “Tissue PLA2R supports lupus-associated membranous nephritis with negative serum testing” is less appropriate because lupus membranous disease has a different immune and clinical context “Tissue PLA2R supports IgG4-related tubulointerstitial disease with membranous change” is less appropriate because IgG subclass patterns do not equate to systemic IgG4-related disease “Tissue PLA2R supports malignancy-associated membranous nephropathy in this setting” is less appropriate because PLA2R positivity instead supports a primary antigen association while age-appropriate screening remains appropriate “Borderline serum PLA2R excludes membranous nephropathy despite positive tissue staining” is less appropriate because tissue antigen can remain detectable when circulating titres are low
Reference: KDIGO 2021 glomerular diseases guideline with 2024 chapter updates: https://kdigo.org/wp-content/uploads/2024/05/KDIGO-2021-Glomerular-Diseases-Guideline_English_2024-Chapter-Updates.pdf