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Primary Membranous Nephropathy, Non-invasive diagnosis and evidence based management

A Mahmood, A N Azam, O Dunne, AM Moran

This presentation is about a clinical scenario of a young adult who presented with nephrotic syndrome complicated with pulmonary embolism, resistant edema and pleural effusion associated with constitutional symptoms. Keeping in view the fact that nephrotic syndrome is not a diagnosis per se in-fact a manifestation of a unique underlying condition. Efforts must be put in to hunt for the culprit cause which needs to be treated in its own right while managing complications and symptoms. Extended evaluation was conducted in this particular case to detect the root cause which revealed the presence of anti phospholipase receptor anti bodies (aPLA2R).Furthermore age appropriate cancer screening was reassuring that aPLA2R is consistent with the diagnosis of primary membranous nephropathy in this particular scenario. Detection of this antibody has diagnostic and prognostic value. Thus periodic serum levels are considered a guiding tool to monitor treatment adequacy.