The Open Urology & Nephrology Journal

ISSN: 1874-303X ― Volume 13, 2020

M-Type Phospholipase A2 Receptor Staining in Children with Idiopathic Membranous Nephropathy: PLA2R Staining in Children with IMN

Yosuke Inaguma1, Atsutoshi Shiratori1, Taku Nakagawa1, Kyoko Kanda1, Makiko Yoshida2, Shigeo Hara3, Hiroshi Kaito1, 4, Kandai Nozu4, Kazumoto Iijima4, Norishige Yoshikawa5, Ryojiro Tanaka1, *
1 Department of Nephrology, Hyogo Prefectural Kobe Children’s Hospital, 1-6-7 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
2 Department of Diagnostic Pathology, Hyogo Prefectural Kobe Children’s Hospital, 1-6-7 Minatojima-minamimachi, Chuoku, Kobe, Hyogo 650-0047, Japan
3 Department of Diagnostic Pathology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
4 Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 kusunokicho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
5 Clinical Research Center, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-8509, Japan



Membranous Nephropathy (MN) is a common cause of nephrotic syndrome in adults that can also occur in children, albeit less frequently. Recently, the M-type phospholipase A2 receptor (PLA2R) was identified as the target antigen in idiopathic membranous nephropathy (IMN), making it a useful marker for diagnosis. However, there are few studies describing the potential role of PLA2R in children with IMN. The aim of this study was to clarify the involvement of PLA2R in childhood IMN.


We enrolled 11 patients diagnosed with IMN from January 1998 to March 2017. We performed PLA2R staining in paraffin-embedded renal biopsy sections. The clinical data were collected from the patients’ medical records.


The median age at biopsy was 6 years (range, 4 to 14 years). A single 6-year-old boy among all pediatric patients with IMN had granular PLA2R staining along his glomerular capillary loops and the prevalence of PLA2R-positivity was 9%. He also showed IgG4 co-dominant staining in terms of IgG subclass. There were no apparent differences in his clinical features such as clinical data at the time of renal biopsy, the time from the treatment initiation to remission, and relapse or renal dysfunction during the follow-up period.


We suggest that PLA2R staining can be a diagnostic tool for patients with IMN of any age, though pediatric patients with IMN have lower prevalence of PLA2R-positive staining than adult patients.

Keywords: Childhood, Idiopathic membranous nephropathy, IgG subclass, Immunofluorescence staining, Phospholipase A2 receptor, Renal biopsy.

Article Information

Identifiers and Pagination:

Year: 2019
Volume: 12
First Page: 27
Last Page: 32
Publisher Id: TOUNJ-12-27
DOI: 10.2174/1874303X01912010027

Article History:

Received Date: 09/01/2019
Revision Received Date: 13/05/2019
Acceptance Date: 16/05/2019
Electronic publication date: 31/07/2019
Collection year: 2019

© 2019 Inaguma et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Nephrology, Hyogo Prefectural Kobe Children’s Hospital, 1-6-7 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan; Tel: +81789457300;
Fax: +81783021023; Email:

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