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Phospholipase a2 receptor antibody testing for hypothyroidism: Receptor autoimmunity: diagnostic and therapeutic implications

The column was cleaned with TBS buffer, eluted with glycine with a pH of 2.

David Stewart
Thursday, September 7, 2017
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  • The concentration of anti-PLA2R-IgG MedicineNet the serum of patients with Graves' disease and thyroid tumor was mostly consistent with that in healthy people. Copy Utility.

  • J Am Soc Nephrol.

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This association is extremely common in autoimmune thyroiditis. Also, 53 serum specimens from healthy volunteers were included as healthy control specimens. Khosroshahi, D.

Additional Technical Information. A titer increase, decrease, or disappearance generally precedes a change in clinical status. Click here for your pricing. Google Scholar. Figure 2.

This helps to hy;othyroidism why renal damage occurred before, after, or simultaneously with thyroid disease. Basu G, Mohapatra A. Immune complex deposition and membranous glomerulonephritis have been shown to coexist with tubulointerstitial nephritis in a minority of patients with IgG4-RD [ 2122 ]. Contrary to the findings of Hoxha et al, 14 which claimed that the discrepancy was not associated with different sensitivities of test methods, Behnert et al 15 demonstrated higher diagnosis sensitivity in IIF than in ELISA.

IgG4-Related Disease

Accepted : 26 December Nat Rev Nephrol. Monomeric C-reactive protein promotes platelets to release mitochondrial DNA in anti-neutrophil cytoplasmic antibody-associated vasculitis. Nephrol Dial Transplant.

All enrolled subjects provided their written informed consent for study participation, and all methods were performed in accordance with the relevant guidelines and regulations. Uppsala, Sweden. Skip to main content. Therefore, in the present study, we used a highly sensitive time-resolved fluoroimmunoassay TRFIA technique to establish a quantitative method for detecting and analyzing PLA2R antibodies in the serum of patients with several common thyroid diseases and IMN.

The most common renal diseases observed in AITD are MN, membranoproliferative hypothyroidiem, minimal change disease, IgA nephropathy, focal segmental glomerulosclerosis, antineutrophil cytoplasmic autoantibody vasculitis, and amyloidosis. All other reagents were of analytical grade and acquired from domestic manufacturers. Membranous glomerulonephritis and autoimmune thyroid disease. N Engl J Med. Thyroid disorders and chronic kidney disease.

International Journal of Rheumatology

Koneczny I, Herbst R. Mean and standard deviations SD were calculated for count values at zero concentration points on the standard curves of 10 groups. There are a variety of potential explanations for this finding. Autoimmunity against cell-surface receptors represents a field of significant interest in autoimmune diagnostics, due to the unique characteristics of syndromes and human pathologies that have over time seen recognized cell-surface molecules as target of immune reactions.

Membranous glomerulonephritis and autoimmune thyroid disease. There were 40 patients with HT, 47 patients with Graves' disease, and 10 patients with nodular goiter. Outreach Solutions Tactics Articles Events. Keywords: autoantibodies; autoimmune; nephropathy; phospholipase A2 receptor; thyroid disease. Eur J Endocrinol. N Engl J Med ;

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Neth J Med. Feifei Zhang, BS. Front Med. Published 10 May Consistent with the findings of previous studies, 11—13 when laboratory values from patients with pMN and those with sMN were compared in the present study, the anti-PLA 2 R levels were significantly higher in patients with pMN.

Keywords: phospholipase A2 receptor, autoantibodies, thyroid disease, autoimmune, nephropathy. N Engl J Med ; Click here for your pricing. Iglesias P, Diez JJ. Statistical analysis was performed using GraphPad Prism 5.

Detecting anti-PLA 2 R at the time of initial diagnosis is recommended, to avoid phospholipass confounding of disease progression and therapy. Chin J Int Med. Anti-N-Methyl- d -aspartate receptor encephalitis: a severe, potentially reversible autoimmune encephalitis. Unique properties distinguish NMDARs from other iGluRs, particularly the high permeability to calcium ions and the requirement for binding of two coagonists, glutamate and glycine, inducing channel activation.

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Test Catalog. An Olympus fluorescence microscope Tokyo, Japan was used for immunohistochemical analyses. Some patients were subjected to immunohistochemical analysis of reecptor thyroid tissue. As HT shares some symptoms with hyperthyroidism and hypothyroidism, and hypothyroidism occurs at a later stage, the generic target antigen PLA2R explains why hyperthyroidism and hypothyroidism symptoms were sometimes accompanied by nephropathy, and patients with hypothyroidism nephropathy were in a more serious condition. Front Endocrinol.

Compliance Category. The tseting recovery was Membranous nephropathy with crescents in a patient with Hashimoto's thyroiditis: a case report. Therapy outcome can be monitored by measuring the anti-phospholipase A2 receptor PLA2R antibody titer. May also include abnormal ranges. Schlumberger W, Hornig N, Lange S, et al: Differential diagnosis of membranous nephropathy with autoantibodies to phospholipase A2 receptor 1.

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The clinical symptoms, results on physical examination, and laboratory tests eg, serological testswhen appropriate, should always be taken into account when considering the diagnosis of primary versus secondary MN. May include disease information, patient result explanation, recommendations, details of testing, associated diseases, explanation of possible patient results. Additional charges apply. Improvement of idiopathic membranous nephropathy diagnosis with ultrasensitive quantitative detection of anti-phospholipase A2 receptor. Test Catalog.

N Engl J Med ; Autoimmune thyroiditis and vitiligo in a child with minimal change nephrotic syndrome. This association is extremely common in autoimmune thyroiditis. Figure 1.

Highlights

Lancet Neurol. Google Scholar. We performed statistical analyses using SPSS statistical software, version Patient 16 [ 26 ] was found to have bilateral kidney masses on a magnetic resonance imaging study performed for evaluation of IgG4-related sclerosing cholangitis.

  • Abraham, S. ACS Chem Neurosci.

  • Concomitant Graves' disease and Hashimoto's thyroiditis, presenting as primary hypothyroidism. Register Sign In.

  • Receive exclusive offers and updates from Oxford Academic. PLA2R autoantibodies and recurrent membranous nephropathy after transplantation.

  • Example Reports. There were 40 patients with HT, 47 patients with Graves' disease, and 10 patients with nodular goiter.

  • Additional studies of IgG4-RD with evidence of membranous nephropathy are important to exclude any definite relationship. Structural-functional features of the thyrotropin receptor: a class A G-protein-coupled receptor at work.

Am J Physiol Renal Physiol. Ito, H. Salant, Donald B. Clin J Am Soc Nephrol. Biochemistry parameters, including blood urea nitrogen BUNserum creatinine, total protein TPalbumin, cholesterol, triglycerides, and hour urine protein, were determined within 2 hours after specimen collection.

View Metrics. Reports of AITD-associated hypothyrooidism have increased gradually over the past 40 years; however, how membranous nephropathy is caused by AITD remains poorly understood. Table 2 The main autoantibodies in receptor autoimmune diseases and their pathogenic actions Full size table. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Received 31 Dec Cornell, S.

Briefly, 1 mg of goat anti-human IgG antibody was added hypothyroidism a small bottle containing 0. The clinical symptoms, results on physical examination, and laboratory tests eg, serological testswhen appropriate, should always be taken into account when considering the diagnosis feceptor primary versus recephor MN. The same results were observed in patients with HT, which is also known as chronic lymphocytic thyroiditis and an AITD disease. Leave this field blank. Analysis on 12 patients with autoimmune thyroid disease associated nephrotic syndrome. This disease was characterized in that high-titer antithyroid antibodies could be detected, large amount of plasmocytes and lymphocytes in thyroid tissue of patients were infiltrated to form lymphoid follicles; lymphocytes would form lymphoblasts after contact with thyroid antigens, and further produce migration inhibitory factors and lymphocytotoxins to warn the patients had T cells and corresponding antigens thereof served as thyrocyte components; it has been reported that a HT, upon initiation of treatment with levothyroxine, he had progressive deterioration in renal function and proteinuria. Last Name.

Introduction

Kidney Int. The column was cleaned with TBS buffer, eluted with glycine with a pH of 2. View at: Google Scholar V.

Unacceptable Conditions. PLA2R autoantibodies and recurrent membranous nephropathy after transplantation. Not Detected. A positive result or greater for phospholipase A2 receptor antibody, IgG in conjunction with other laboratory and clinical findings, supports a diagnosis of primary membranous glomerulonephritis pMGN.

View at: Google Scholar V. Contrary to the findings of Hoxha et al, 14 which claimed that the discrepancy was not associated with different sensitivities of test methods, Behnert et al 15 demonstrated higher diagnosis hypothyroidism in IIF than in ELISA. The column was cleaned with TBS buffer, eluted with glycine with a pH of 2. Imai, T. Can J Diabetes. Methods: We applied a highly sensitive time-resolved fluoroimmunoassay to quantitatively detect the concentration of phospholipase A2 receptor PLA2R antibodies in the serum of patients with Graves' disease, Hashimoto's thyroiditis HTnephrotic patients with idiopathic membranous nephropathy IMNand normal controls. Sign In or Create an Account.

Schlumberger W, Hornig N, Lange S, et al: Differential diagnosis of membranous nephropathy with autoantibodies to phospholipase A2 receptor 1. Figure 4. Some patients were subjected to immunohistochemical analysis of the thyroid tissue. Test Catalog. The glomerular filtration rate increased in patients with graves' disease. The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice.

Associated Data

Idiopathic membranous nephropathy IMN is an organ-specific autoimmune disorder and a leading cause of nephrotic syndrome in adults. The overall qualitative agreement of anti-PLA 2 R was Autoimmun Highlights 11, 1

Patients with AITD may develop secondary renal damage, which may represent nephrotic syndrome and or less frequently renal function damage Chin J Pract Int Med. However, why some renal damage occurs prior to thyroid disease symptoms is unclear. Min: 0. These complexes are mainly responsible for alterations in renal function by depositing on the basement membrane of the glomeruli 8. The ratio of each measured value to its theoretical value was then calculated.

Sign In or Create an Account. J Am Soc Nephrol. The phospholipasd between elevated serum IgG4 and distinctive patterns of organ involvement was first recognized in autoimmune pancreatitis [ 4 ], but subsequent observations led to the identification of this disease in nearly all organ systems [ 125 ]. Am J Kidney Dis. A year odyssey.

Materials and Methods

Immunohistochemical Results Immunohistochemical analysis was performed on pathological sections of thyroid tissue obtained from in-patients undergoing thyroidectomy with HT and nodular goiter, as well as the nephridial tissue from patients with IMN using goat antibodies against PLA2R Figure 4. Sghirlanzoni, M. This association is extremely common in autoimmune thyroiditis.

Zeng et al. Iglesias P, Diez JJ. The intra- and inter-batch coefficients of phospjolipase were 4. IgG4-related disease IgG4-RD is a multiorgan system fibroinflammatory condition defined by a tendency to form tumorous lesions in various organs including the pancreas, salivary and lacrimal glands, biliary tract, liver, lung, and kidney, aorta [ 1 ].

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Thyroid antigen-antibody nephritis. Google Scholar. Figure 2. This may be one cause of AITD-associated nephropathy. We would like to thank Editage www.

N Engl J Med. The intra- and inter batch coefficients of variation were determined from measurements obtained from quality-controlled samples of three different concentrations. Download Test. In addition, 46 patients were confirmed to have IMN without cancer, lupus nephropathy, diabetic nephropathy, hepatitis B virus-associated nephritis, purpura nephritisand 64 controls were included as healthy physical controls without thyroid disease, nephropathy, gastroduodenal disorders, or liver disease. Immunohistochemical analysis was further conducted on nephridial tissues from patients with IMN and thyroid tissues from patients with HT. The same results were observed in patients with HT, which is also known as chronic lymphocytic thyroiditis and an AITD disease. The pathophysiology links between thyroid dysfunction and glomerulonephritis involve proteinuria and formation of immune complexes.

Thyroid antigen-antibody nephritis. Moreover, anti-PLA 2 R is now expected to be a biomarker of pMN activity, a cue for immunosuppressive therapy monitoring, and a tool for predicting disease outcomes. Unizony, D.

Membranous nephropathy MN is a common hypothyroldism of nephritic syndrome in adults. Cheuk and J. Chapman, D. Also, 53 serum specimens from healthy volunteers were included as healthy control specimens. Given the consistency of pathological features across involved organs in IgG4-RD, we believe that our findings likely represent the true nature of the relationship between IgG4-RD and antibodies to the PLA2-R, namely, that there is none. Google Scholar. All other reagents were of analytical grade and acquired from domestic manufacturers.

  • PLA2R antibody concentration in the serum and the area under the receiver operating characteristic curve in patients with HT and IMN were increased significantly. Kuroki, M.

  • Basu G, Mohapatra A.

  • Kawa, A.

  • A novel time-resolved fluoroimmunoassay for the quantitative detection of antibodies against the phospholipase A2 receptor. Membranous nephropathy with crescents in a patient with Hashimoto's thyroiditis: a case report.

  • As early asthe hypothesis of the role of antibodies against the acetylcholine receptor AChR in the pathogenesis of myasthenia gravis MG was assumed and then confirmed [ 34 ].

N Engl J Med ; 2. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. CPT coding is the hyppothyroidism responsibility of the billing party. The membrances of both sides of the thyrocytes from patients with HT and glomerular podocytes from patients with IMN were obviously stained, indicating that both patient groups contained the same PLA2R target antigens. Therefore, AITD-associated nephropathy has attracted increased attention 8. Pediatr Nephrol.

CPT coding is the sole responsibility of the billing party. Membranous nephropathy: recent travels and new roads ahead. Specimen Required Patient Preparation. PubMed Abstract Google Scholar. A positive result or greater for phospholipase A2 receptor antibody, IgG in conjunction with other laboratory and clinical findings, supports a diagnosis of primary membranous glomerulonephritis pMGN.

M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. Components Components of test. We would like to thank Editage www. Unacceptable Conditions.

Phospholipase a2 receptor antibody testing for hypothyroidism insights into the molecular mechanisms of myasthenia gravis and their therapeutic implications. The etiology of pMN was obscure until the landmark study by Beck et al 5 inthe results of which demonstrated that M-type phospholipase A2 receptor PLA 2 Ra transmembrane glycoprotein expressed on podocytes, was the main target antigen of the autoantibody in pMN. IgG4 Plasma Cell Quantitation Immunohistochemical staining was performed as previously described [ 12 ]. Introduction IgG4-related disease IgG4-RD is a multiorgan system fibroinflammatory condition defined by a tendency to form tumorous lesions in various organs including the pancreas, salivary and lacrimal glands, biliary tract, liver, lung, and kidney, aorta [ 1 ].

Testing for association is extremely common in autoimmune thyroiditis. A widely accepted viewpoint is that in patients with pMN, subepithelial deposition occurs in situ phospho,ipase the binding of circulating anti-PLA 2 R on podocytes, leading to activation of complement and a cascade of events subsequent to nephritic syndrome. Some patients were subjected to immunohistochemical analysis of the thyroid tissue. Neth J Med. Fervenza, G. Structural-functional features of the thyrotropin receptor: a class A G-protein-coupled receptor at work. Analysis of the Sample Results The samples were divided into five groups.

Article Google Scholar 4. Saeki, H. An immunofluorescence test for phospholipase-A 2 -receptor antibodies and its clinical usefulness in patients with membranous glomerulonephritis. Cite this article Tozzoli, R.

PubMed Article Google Scholar. The iGluRs are important for both synaptic transmission and plasticity, hhpothyroidism fundamental in molecular mechanisms of learning and memory, and can be divided in 3 different groups: NMDARs, amino-hydroxy-methyl-isoxazolepropionic acid receptors AMPARs and kainate receptors [ 43 ]. The glomerular lesions of IgG4-RD described to date have included mesangial proliferative glomerulonephritis, membranous nephropathy, membranoproliferative glomerulonephritis, and endocapillary proliferative glomerulonephritis [ 1929 ]. Immunohistochemical Results Immunohistochemical analysis was performed on pathological sections of thyroid tissue obtained from in-patients undergoing thyroidectomy with HT and nodular goiter, as well as the nephridial tissue from patients with IMN using goat antibodies against PLA2R Figure 4. Diagnostic accuracy of PLA2R autoantibodies and glomerular staining for the differentiation of idiopathic and secondary membranous nephropathy: an updated meta-analysis.

Myasthenia gravis: a new hypothesis. Table 3 Assay methods for receptor autoantibodies Full size table. Can J Diabetes. Davies TF, Latif R. Unique properties distinguish NMDARs from other iGluRs, particularly the high permeability to calcium ions and the requirement for binding of two coagonists, glutamate and glycine, inducing channel activation. In this study, we report that the sensitivity of anti-PLA 2 R was Patients with sMN had lower cholesterol and hour urine protein levels than patients with pMN and higher levels than in controls.

Therefore, AITD-associated nephropathy has attracted increased testng 8. The incidence of thyroid disease and nephropathy is high, with 4. Aims: To develop a highly sensitive immunoassay for PLA2R autoantibodies and study the relationship between PLA2R autoantibodies and autoimmune thyroid disease-associated nephropathy. Table 1. Iglesias P, Diez JJ. The average recovery was

ORIGINAL RESEARCH article

M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. Aliases Other names that describe the test. Client ID. The clinical symptoms, results on physical examination, and laboratory tests eg, serological testswhen appropriate, should always be taken into account when considering the diagnosis of primary versus secondary MN. Mnemonic Unique test identifier.

As critical human organs, the thyroid and kidney are very closely related. Some patients were hypothyroodism to immunohistochemical analysis of the thyroid tissue. The column was cleaned with TBS buffer, eluted with glycine with a pH of 2. Briefly, 1 mg of goat anti-human IgG antibody was added to a small bottle containing 0.

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The overall correlation coefficient was 0. Saeki, N. Histopathologic features considered to be highly suggestive of IgG4-RD diagnosis included lymphoplasmacytic infiltrates and storiform fibrosis within involved organs. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Cornell, S. Autoimmun Highlights 11, 1

For two centuries GD has been known for its clinical characteristics and the evolution of its knowledge derived from seminal contributions antibosy several authors Flaiani, Parry, Graves and von Basedow [ 11 ]. PMN was diagnosed in patients with biopsy-proven MN but without laboratory or clinical signs of known underlying diseases or suspected drug exposure. Cite this article Tozzoli, R. This helps to explain why renal damage occurred before, after, or simultaneously with thyroid disease. A comparison of three different immunoassays for the diagnosis of idiopathic membranous nephropathy. Watson, D. After expression on the plasma membrane, the full-length TSHR undergoes cleavage within the hinge region [ 16 ].

Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. These subunits tewting a similar structure that involves four domains: a large extracellular amino-terminal domain NTDan agonist binding domain ABDa pore transmembrane domain TMD and an intracellular domain CTD [ 44 ]. An indirect immunofluorescence technique was applied to the thyroid surgical tissue and renal biopsy tissue. The overall qualitative agreement of anti-PLA 2 R was Table 2 The main autoantibodies in receptor autoimmune diseases and their pathogenic actions Full size table.

Download Test. Table 1. The pathogenesis of AITD combined with renal damage is not completely understood and has been suggested to be associated with the formation of in situ immune complexes resulting from deposition of thyroglobulin and thyroid microsomal antigens in the glomerulus 13 A titer increase, decrease, or disappearance generally precedes a change in clinical status. The intra- and inter batch coefficients of variation were determined from measurements obtained from quality-controlled samples of three different concentrations. Compliance Category. Sera from 46 patients with IMN, 40 patients with HT, 47 patients with Graves' disease, 10 patients with nodular goiter, and 64 healthy controls were examined.

Sci Rep. Phospholipase A2 receptor antibody IgG4 subclass improves sensitivity and specificity in the diagnosis of idiopathic membranous nephropathy. May also include abnormal ranges. N Engl J Med ; 2. Immunohistochemical analysis was further conducted on nephridial tissues from patients with IMN and thyroid tissues from patients with HT. Min: 0. Utilization Management Resource Center Algorithms.

Prevalence

Test Catalog. This test should not be used as a stand-alone test but an adjunct to other clinical information. PLA2R antibody concentration in the serum and the area under the receiver operating characteristic curve in patients with HT and IMN were increased significantly.

Fervenza, D. Kidney Blood Press Res. Khosroshahi and J. A comparison of three different immunoassays for the diagnosis of idiopathic membranous nephropathy. Differential diagnosis of membranous nephropathy with autoantibodies to phospholipase A2 receptor 1.

Pediatr Nephrol. The incidence of thyroid disease and nephropathy is high, with 4. Membranous glomerulonephritis and autoimmune thyroid disease. Briefly, 1 mg of goat anti-human IgG antibody was added to a small bottle containing 0. N Engl J Med ;

Test Information

N Engl J Med. Different hypotheses have been proposed regarding the relationship between AITD and glomerulopathies, and several potential mechanisms for this association have been considered Next, horseradish peroxidase-labeled goat anti-rabbit secondary antibodies were added.

Ir Med J. Moreover, we performed immunohistochemical analysis of pathological samples obtained from patients to investigate the clinical significance of AITD in relation to PLA2R. Metrics details. This finding is congruent with previous reports that IgG4 predominates in the immune deposits of renal biopsy specimens of IMN. A unique finding of GD, not present in healthy subjects or in the animal kingdom, is the presence of TSHR autoantibodies TRAbsmeasurable in the majority of patients [ 1519 ]. Diagnostic test accuracy of serum anti-PLA2R autoantibodies and glomerular PLA2R antigen for diagnosing idiopathic membranous nephropathy: an updated meta-analysis. Role of anti-receptor autoantibodies in pathophysiology of scleroderma.

Membranous nephropathy with crescents in a patient with Hashimoto's thyroiditis: a case report. Useful For Suggests clinical disorders or phospholipase a2 receptor antibody testing for hypothyroidism where the test may be helpful Distinguishing primary from secondary membranous phosphholipase. Independent samples t -test, Wilcoxon test, and Mann-Whitney test were used to compare groups. Aliases Other names that describe the test. Improvement of idiopathic membranous nephropathy diagnosis with ultrasensitive quantitative detection of anti-phospholipase A2 receptor. There were 40 patients with HT, 47 patients with Graves' disease, and 10 patients with nodular goiter. A Roche electrochemistry luminescence instrument E was used to detect various thyroid serological indicators.

Clinical Significance

Patrick J, Lindstrom JM. Autoimmun Rev. Membranous nephropathy—one morphologic pattern with different diseases.

Additional charges apply. An indirect immunofluorescence technique was applied to the thyroid surgical hupothyroidism and renal biopsy tissue. We immunohistochemically analyzed the existing PLA2R target antigen in the thyroid tissue of patients with Graves' disease and HT, as well as the nephridial tissue of nephrotic patients with IMN. Autoimmune thyroiditis and vitiligo in a child with minimal change nephrotic syndrome. Test Catalog. Table 1 presents the level of urine protein, hematuria, serum creatinine Scrglomerular filtration rate, and anti-PLA2R-IgG in the serum of different patients with thyroid disease and IMN. Methodology Process es used to perform the test.

N Engl J Med ; 2. Moreover, we performed immunohistochemical analysis of pathological samples obtained from patients to investigate the clinical significance of AITD in relation to PLA2R. Skip to main content. Copy Utility. A renal biopsy revealed coexistent necrotizing and crescentic glomerulonephritis and membranous nephropathy. The pathogenesis of AITD combined with renal damage is not completely understood and has been suggested to be associated with the formation of in situ immune complexes resulting from deposition of thyroglobulin and thyroid microsomal antigens in the glomerulus 13 ,

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