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Abstract: TH-PO706

FAT1 as an Antigen in Antibody-Mediated Rejection-Associated Membranous Nephropathy

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Al-Rabadi, Laith, University of Utah Health, Salt Lake City, Utah, United States
  • Caza, Tiffany, Arkana Laboratories, Little Rock, Arkansas, United States
  • Larsen, Christopher Patrick, Arkana Laboratories, Little Rock, Arkansas, United States
  • Beck, Laurence H., Boston Medical Center, Boston, Massachusetts, United States
Introduction

Membranous nephropathy can be a manifestation of antibody mediated rejection (ABMR). While recurrent membranous nephropathy has been mostly attributed to PLA2R, the targeted antigen in ABMR-associated membranous remains unknown. FAT1 has been recently found to be an antigen in post hematopoietic stem cell transplant but not in de novo membranous nephropathy related to ABMR.

Case Description

Patient has evidence of ABMR evidenced by presence of peritubular capillaritis, glomerulitis, and positive donor specific antibody ( HLA DQ1 11,000). In addition to microcirculation inflammation, membranous nephropathy was identified on kidney biopsy. Serum from the patient with De novo membranous MN recognizes HGE at a high molecular weight band ( higher than THSD7A and PLA2R). We sought to investigate whether FAT1 can be the targeted antigen given the high molecular weight on western blotting. Immunostaining revealed a granular pattern of FAT1 along the capillary wall.

Discussion

FAT1 can be the antigen implicated in membranous nephropathy related to ABMR. We are currently screening a larger cohort to validate our findings.