Treatment of Membranous Nephropathy in Patients With THSD7A Antibodies Using Immunoadsorption

Abstract

Antibodies against THSD7A (thrombospondin type 1 domain-containing protein 7A) have been proposed to play a causal role in the development of nephrotic syndrome in patients with THSD7A antibody-positive membranous nephropathy. We hypothesized that removal of these antibodies from plasma could lead to a rapid reduction in proteinuria. Using immunoadsorption to reduce THSD7A antibodies led to a rapid reduction in proteinuria in 2 patients with THSD7A antibody-positive membranous nephropathy. Moreover, our findings support and strengthen the pathogenic role of the antibodies in the development of nephrotic syndrome in patients with THSD7A antibody-positive membranous nephropathy. Taken together, these 2 cases suggest that immunoadsorption could be a useful tool in the treatment of patients with THSD7A antibody-positive membranous nephropathy.

Keywords: THSD7A (thrombospondin type 1 domain-containing protein 7A); autoantibodies; case report; immunoadsorption; kidney biopsy; malignancy-associated MN; membranous nephropathy (MN); nephrotic syndrome (NS); proteinuria; urinary protein-creatinine ratio (UPCR).