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HelpMayo Test ID PLAIF Phospholipase A2 Receptor (PLA2R), Renal Biopsy
Ordering Guidance
This test will report as negative or positive for autoantibodies to phospholipase A2 receptor (PLA2R).
If additional interpretation/analysis is needed, request PATHC / Pathology Consultation along with this test and send the corresponding renal pathology light microscopy and immunofluorescence (IF) slides (or IF images on a CD), electron microscopy images (prints or CD), and the pathology report.
Shipping Instructions
1. Advise shipping unstained slides or tissue block specimens frozen in Styrofoam transportation coolers filled with dry ice to ensure specimens are received at required specimen stability temperature.
2. Attach the green pathology address label included in the kit to the outside of the transport container.
Necessary Information
A pathology/diagnostic report is required.
Specimen Required
Specimen Type: Kidney tissue
Preferred: Frozen unstained slides (unfixed)
Slides: 2 frozen tissue unstained positively charged glass slides (25- x 75- x 1-mm) per test ordered; sections 4-microns thick, centered on the slide, and submitted on dry ice.
Acceptable: Frozen Unfixed Tissue Block (OCT)
Container/Tube: Entire specimen
Collection Instructions: Send tissue embedded in OCT on dry ice.
Acceptable: Wet Tissue
Supplies: Renal Biopsy Kit (T231)
Container/Tube: Renal Biopsy Kit, Zeus/Michel's
Specimen Volume: Entire specimen
Collection Instructions: Collect specimens according to the instructions in Renal Biopsy Procedure for Handling Tissue for Light Microscopy, Immunofluorescent Histology, and Electron Microscopy.
Additional Information: If standard immunoglobulin and complement immunofluorescence have already been performed, submit the residual frozen tissue (must contain glomeruli) on dry ice.
Special Instructions
Method Name
Immunofluorescence
Reporting Name
PLA2R ImmunofluorescenceSpecimen Type
SpecialSpecimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Special | Frozen (preferred) | ||
| Ambient | |||
| Refrigerated | |||
Reject Due To
| Ambient slides | Reject |
Clinical Information
Membranous nephropathy is the most common cause of nephrotic syndrome in white adults. Eighty-five percent of membranous nephropathy cases are primary or idiopathic, and the other 15% are secondary. Phospholipase A2 receptor (PLA2R) is an antigen located on podocytes. The majority of cases of primary membranous nephropathy have circulating autoantibodies against PLA2R.
Interpretation
This test, when not accompanied by a pathology consultation request, will be reported as either positive or negative.
Cautions
No significant cautionary statements.
Clinical Reference
1. Larsen CP, Messias NC, Silva FG, Messias E, Walker PD: Determination of primary versus secondary membranous glomerulopathy utilizing phospholipase A2 receptor staining in renal biopsies. Mod Pathol. 2013 May;26(5):709-715
2. Svobodova B, Honsova E, Ronco P, Tesar V, Debiec H: Kidney biopsy is a sensitive tool for retrospective diagnosis of PLA2R-related membranous nephropathy. Nephrol Dial Transplant. 2013 Jul;28(7):1839-1844
3. Cossey LN, Walker PD, Larsen CP: Phospholipase A2 receptor staining in pediatric idiopathic membranous glomerulopathy. Pediatr Nephrol. 2013 Dec;28(12):2307-2311
4. Larsen CP, Walker PD: Phospholipase A2 receptor (PLA2R) staining is useful in the determination of de novo versus recurrent membranous glomerulopathy. Transplantation. 2013 May;95(10):1259-1262
5. Tomas NM, Beck LH Jr, Meyer-Schwesinger C, et al: Thrombospondin type-1 domain-containing 7A in idiopathic membranous nephropathy. N Engl J Med. 2014 Dec 11;371(24):2277-2287
Method Description
Indirect immunofluorescence staining on sections of frozen tissue.(Unpublished Mayo method)
Day(s) Performed
Monday through Friday
Report Available
1 to 2 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
88346-primary IF
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| PLAIF | PLA2R Immunofluorescence | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 71225 | Interpretation | 59465-5 |
| 71226 | Participated in the Interpretation | No LOINC Needed |
| 71227 | Report electronically signed by | 19139-5 |
| 71228 | Addendum | 35265-8 |
| 71229 | Gross Description | 22634-0 |
| 71230 | Material Received | 81178-6 |
| 71617 | Disclaimer | 62364-5 |
| 71847 | Case Number | 80398-1 |