Which disease is caused by anti-phospholipase 2 antibody:

Ans. b. MGNMEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS (MPGN)Type I--subendothelial immune complex (IC) deposits with granular IF; "tram-track" appearance on PAS stain (See figure A) and HandE stain (See figure B) due to GBM splitting caused by mesangial in growth.Type II--also called dense deposit disease.MPGN is a nephritic syndrome that often copresents with nephrotic syndrome.Type I may be 2deg to hepatitis B or C infection.May also be idiopathic.Type II is associated with C3 nephritic factor (IgG antibody that stabilizes C3 convertase - persistent complement activation - decreases C3 levels).MINIMAL CHANGE DISEASE (MCD) LM: normal glomeruli (lipid may be seen in PCT cells).IF: [?].EM: effacement of foot processes (See figure C).Most common cause of nephrotic syndrome in children. Often 1deg (idiopathic) and may be triggered by recent infection, immunization, immune stimulus.Rarely, may be 2deg to lymphoma (eg, cytokine-mediated damage).1deg disease has excellent response to corticosteroids.FOCAL SEGMENTAL GLOMERULOSCLEROSIS (FSGN)LM--segmental sclerosis and hyalinosis (See figure D).IF--often [?], but may be for nonspecific focal deposits of IgM, C3, Cl.EM--effacement of foot process similar to minimal change disease.Most common cause of nephrotic syndrome in African Americans and Hispanics.Can be 1deg (idiopathic) or 2deg to other conditions (e.g., HIV infection, sickle cell disease, heroin abuse, massive obesity, interferon treatment, chronic kidney disease due to congenital malformations).1deg disease has inconsistent response to steroids.May progress to chronic renal disease Membranous glomerulonephritis (MGN)LM--diffuse capillary and GBM thickening (See figure E).IF--granular as a result of immune complex deposition. Nephrotic presentation of SLE.EM--"spike and dome" appearance with subepithelial deposits.Most common cause of 1deg nephrotic syndrome in Caucasian adults.Can be 1deg (e.g., antibodies to phospholipase A2 receptor) or 2deg to drugs (e.g., NSAIDs, penicillamine, gold), infections (e.g., HBV, HCV, and syphilis), SLE, or solid tumors.1deg disease has poor response to steroids.May progress to chronic renal disease.