American Board of Internal Medicine (ABIM) Certification Practice Exam

What antibody is commonly associated with primary membranous glomerulopathy?

1. Anti-nuclear antibody (ANA)

2. Phospholipase A2 receptor (PLA2R)

3. Amyloid A protein

4. Anti-DNA antibody

The correct answer is: Phospholipase A2 receptor (PLA2R)

Primary membranous glomerulopathy is a type of kidney disease characterized by the presence of subepithelial immune complex deposition, leading to damage to the glomerular filtration barrier. The Phospholipase A2 receptor (PLA2R) is an antibody that is commonly and specifically associated with this condition. In most patients with primary membranous glomerulopathy, the serological identification of PLA2R antibodies serves as a key diagnostic tool. The presence of these antibodies indicates an autoimmune response directed against the PLA2 receptor, which is located on the podocytes in the kidneys. This immune response is considered a significant factor in the pathogenesis of primary membranous glomerulopathy. In contrast, other antibodies like anti-nuclear antibodies (ANA), amyloid A protein, and anti-DNA antibodies are associated with different diseases. For instance, ANAs are commonly linked to systemic lupus erythematosus and other autoimmune conditions, while anti-DNA antibodies specifically point towards lupus. Amyloid A protein is related to amyloidosis, not primary membranous glomerulopathy. Therefore, the identification of PLA2R antibodies is central to recognizing and diagnosing primary membranous glomerulopathy, truly