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HelpOrder Code PMND1 Primary Membranous Nephropathy Diagnostic Cascade, Serum
Specimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Useful For
Distinguishing primary from secondary membranous nephropathy using an algorithmic approach
Monitoring patients with membranous nephropathy at very low antibody titers
Screening for anti-phospholipase A2 receptor antibodies
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| EURO | Phospholipase A2 Receptor, ELISA, S | Yes, (Order PLA2M) | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| PLA2I | PLA2R, Immunofluorescence, S | Yes | No |
| THSD7 | THSD7A Ab, S | Yes | No |
Testing Algorithm
The phospholipase A2 receptor (PLA2R) enzyme-linked immunosorbent assay (ELISA) is initially performed.
If the PLA2R ELISA result is less than 20, then the PLA2R immunofluorescence testing will be performed at an additional charge.
If the PLA2R immunofluorescence result is negative, thrombospondin type-1 domain-containing 7A (THSD7A) antibody testing will be performed at an additional charge.
Method Name
EURO: Enzyme-Linked Immunosorbent Assay (ELISA)
PLA2I, THSD7: Indirect Immunofluorescence Assay (IFA)
Reporting Name
Prim Membranous Nephropathy Diag, SSpecimen Type
SerumSpecimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 14 days |
| Frozen | 14 days | |
| Ambient | 8 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
Reference Values
ANTI-PHOSPHOLIPASE A2 RECEPTOR (PLA2R) ENZYME-LINKED IMMUNOSORBENT ASSAY:
<14 RU/mL: Negative
14 to 19 RU/mL: Borderline
≥20 RU/mL: Positive
PLA2R IMMUNOFLUORESCENCE:
Negative
THROMBOSPONDIN TYPE-1 DOMAIN-CONTAINING 7A ANTIBODIES:
Negative
Method Description
Enzyme-Linked Immunosorbent Assay:
The test kit provides microtiter strips, each with 8 break-off reagent wells. In the case of positive samples, specific IgG antibodies (also IgA and IgM) will bind to the antigens. To detect the bound antibodies, a second incubation is carried out using an enzyme-labelled antihuman IgG (enzyme conjugate) catalyzing a color reaction.(Package insert: Anti-PLA2R ELISA [IgG] Kit, EUROIMMUN US; V 07/08/2020)
Indirect Immunofluorescence Assay:
Diluted patient samples are incubated with combinations of substrates. If the reaction is positive, specific antibodies of classes IgA, IgG, and IgM attach to the antigens. In a second step, the attached antibodies are stained with fluorescein-labelled antihuman antibodies and made visible with a fluorescence microscope.(Package inserts: Anti-PLA2R IFA Kit, EUROIMMUN US; V 09/27/2018; Anti-THSD7A IIFT EUROPattern, EUROIMMUN US;V 06/11/2019)
Day(s) Performed
Monday, Wednesday, Friday
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
83520
86255 (x1 or x2, if applicable)
Forms
If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.