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Test Code PLAIF Phospholipase A2 Receptor (PLA2R), Renal Biopsy

Reporting Name

PLA2R Immunofluorescence

Method Name

Immunofluorescence

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Special


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.


Specimen Stability Information

Specimen Type Temperature Time Special Container
Special Frozen (preferred)
  Ambient 
  Refrigerated 

Reject Due To

Ambient slides Reject

Day(s) Performed

Monday through Friday

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

Forms

1. Renal Biopsy Patient Information

2. If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.

Secondary ID

70592

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)

Report Available

1 to 2 days

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.