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The antibody most often implicated is the M\u2010type phospholipase A2 receptor (PLA2R) antibody, found in &gt;70% of primary membranous nephropathy cases. First\u2010line therapy is immunosuppressive in nature, but for patients who are treatment\u2010resistant there is a significant risk of end\u2010stage renal disease and mortality. Hypercholesterolemia is not only a side effect of nephrotic syndrome, but also its presence may worsen renal function. A recent single\u2010arm observational study in Japan found that low\u2010density lipoprotein apheresis (LDL\u2010A) was able to ameliorate nephrotic syndrome in half of patients who were resistant to medication. We present a case of treatment resistant PLA2R negative membranous nephropathy who had significant improvement following two courses of LDL\u2010A. To our knowledge, this is the first such reported case in the United States.<\/jats:p>","DOI":"10.1002\/jca.21677","type":"journal-article","created":{"date-parts":[[2018,12,11]],"date-time":"2018-12-11T02:48:38Z","timestamp":1544496518000},"page":"495-498","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Treatment\u2010resistant PLA2R\u2010negative membranous nephropathy responsive to low\u2010density lipoprotein apheresis"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0202-7058","authenticated-orcid":false,"given":"James M.","family":"Szymanski","sequence":"first","affiliation":[{"name":"Department of Transfusion Medicine National Institutes of Health Clinical Center Bethesda MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meryl","family":"Waldman","sequence":"additional","affiliation":[{"name":"National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) National Institutes of Health Bethesda MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cathy","family":"Conry\u2010Cantilena","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine National Institutes of Health Clinical Center Bethesda MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamille Aisha","family":"West","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine National Institutes of Health Clinical Center Bethesda MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,12,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000112466"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.09.048"},{"key":"e_1_2_7_4_1","first-page":"207","article-title":"Augmented expression of glomerular basement membrane specific type IV collagen isoforms (alpha3\u2010alpha5) in experimental membranous nephropathy","volume":"110","author":"Minto AW","year":"1998","journal-title":"Proc Assoc Am Physicians"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2004121098"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2012030242"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409354"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfr220"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000437338"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.10131011"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(82)91513-6"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(12)70171-3"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V1482084"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-013-0930-5"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-014-0996-8"},{"key":"e_1_2_7_16_1","unstructured":"FDA Liposorber\u00ae LA\u201015 system summary of safety and probable benefit.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf17\/H170002B.pdf. 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