How do you approach the management of patients with suspected membranous lupus nephritis who are found to have positive PLA2R antibodies?  

In a patient with known SLE with proteinuria > 500 mg/g and (+) PLA2R antibodies in the serum, a kidney biopsy would be warranted.  PLA2R staining should be performed on the kidney biopsy. PLA2R staining must co-localize on the subepithelial aspect in a granular fashion similar to IgG in PL...