{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T09:27:57Z","timestamp":1777973277370,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2018,7,2]],"date-time":"2018-07-02T00:00:00Z","timestamp":1530489600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>De novo membranous nephropathy (dnMN) contributes to graft failure, but the pathophysiology of the disease remains poorly understood. We defined cases exhibiting granular Immunoglobulin G (IgG) immunofluorescence staining but lacking dense deposits on electron microscopy as being of \u2018dnMN stage 0\u2019; we studied the associated clinicopathological features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied 4653 allograft biopsy specimens (from 1747 cases treated in the Department of Urology, Tokyo Women\u2019s Medical University) and found 42 cases of allograft membranous nephropathy, of which 28 (1.6%) were diagnosed as dnMN. Of these, five cases (0.06%) fulfilled the criteria for dnMN stage 0.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All five cases were diagnosed based on biopsies indicating increased serum levels of creatinine. Proteinuria status varied from negative to 2+. The median period from transplantation to allograft biopsy was 4068 days. Four of the five cases exhibited suspicious antibody\u2010mediated rejection together with dnMN. The glomerular capillaries of all cases were C4d\u2010positive, as were the peritubular capillaries of three of the four ABO\u2010compatible transplants. In terms of IgG subclass, IgG1 and IgG3 predominated in all cases, and phospholipase A2 receptor status (evaluated via immunoreactivity) was negative in all cases. We examined two cases by immunoelectron microscopy using anti\u2010IgG and anti\u2010C4d antibodies. We found subendothelial and intramembranous deposits expressing both IgG and C4d, corresponding to positivity in immunofluorescence analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We confirmed the existence of dnMN stage 0 by focusing on granular IgG immunofluorescence positivity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.13274","type":"journal-article","created":{"date-parts":[[2018,7,3]],"date-time":"2018-07-03T05:00:51Z","timestamp":1530594051000},"page":"63-69","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinicopathological study of de novo membranous nephropathy of \u2018stage 0\u2019 after kidney transplantation"],"prefix":"10.1111","volume":"23","author":[{"given":"Ai","family":"Katsuma","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuyuki","family":"Nakada","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Izumi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeru","family":"Horita","sequence":"additional","affiliation":[{"name":"Department of Medicine Kidney Center, Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruki","family":"Katsumata","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akimitsu","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohei","family":"Unagami","sequence":"additional","affiliation":[{"name":"Department of Nephrology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayoshi","family":"Okumi","sequence":"additional","affiliation":[{"name":"Department of Urology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Urology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Yokoo","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Yamaguchi's Pathological Laboratory  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazunari","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Urology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Japan Academic Consortium of Kidney Transplantation (JACK)","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,7,2]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"314","article-title":"Recurrence of de novo membranous glomerulonephritis on renal grafts","volume":"41","author":"Heidet L","year":"1994","journal-title":"Clin. 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