Background: Primary membranous nephropathy (MN) is caused by circulating autoantibodies binding to antigens on the podocyte surface. PLAR1 is the main target antigen in 70%-80% of cases, but the pathogenesis is unresolved in 10%-15% of patients.
Methods: We used native western blotting to identify IgG4 autoantibodies, which bind an antigen endogenously expressed on podocyte membranes, in the serum of the index patient with MN.