Test Id : MSMN
Membranous Nephropathy Target Antigen Identification, Mass Spectrometry, Tissue
Useful For
Suggests clinical disorders or settings where the test may be helpful
Identification of antigen in membranous nephropathy
Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| MSMNT | Mass Spectrometry, MN TC | No, (Bill Only) | No |
| MNLCP | Microdissection, Laser Capture, MN | No, (Bill Only) | No |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Requests for this test are reviewed by a Mayo Clinic renal pathologist prior to testing. After review of the submitted pathology report, electron microscopy images, phospholipase A2 receptor (PLA2R) staining results, and paraffin block, testing will proceed. If PLA2R results are not available, the pathologist may contact the ordering healthcare professional for the results or for additional specimen (frozen material/slides) to conduct the studies at Mayo Clinic Laboratories.
Method Name
A short description of the method used to perform the test
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
MS
MSMN
GPMATAMS
RBMNTAMSST
Membranous mass spectrometry
Membranous nephropathy
Membranous nephropathy antigens
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Requests for this test are reviewed by a Mayo Clinic renal pathologist prior to testing. After review of the submitted pathology report, electron microscopy images, phospholipase A2 receptor (PLA2R) staining results, and paraffin block, testing will proceed. If PLA2R results are not available, the pathologist may contact the ordering healthcare professional for the results or for additional specimen (frozen material/slides) to conduct the studies at Mayo Clinic Laboratories.
Specimen Type
Describes the specimen type validated for testing
Special
Ordering Guidance
This test should be performed on cases with a confirmed diagnosis of membranous nephropathy. Ideally, these cases should already be confirmed as phospholipase A2 receptor (PLA2R) negative, based on PLA2R immunohistochemistry (IHC) or immunofluorescence (IF) testing, not PLA2R serology testing.
If PLA2R IHC or IF testing has not been performed, order test PLAIF / Phospholipase A2 Receptor (PLA2R), Renal Biopsy and submit the additional required specimen.
Additional Testing Requirements
If phospholipase A2 receptor testing using immunohistochemistry or immunofluorescence (IF) has not previously been performed, PLAIF / Phospholipase A2 Receptor (PLA2R), Renal Biopsy must also be ordered and will be charged separately. An additional frozen IF block or frozen unstained slides will be required.
Necessary Information
The following information is required. Testing will not proceed without this information.
Note: Images can be submitted for the request via Mayo Clinic ImageShare (preferred) or external storage device. Be aware that ImageShare does not support the upload of Pathology whole slide images.
1. Preliminary pathology report and clinical history
2. Electron microscopy (EM) images
3. Immunofluorescence (IF) slides/images if EM images are not available.
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Specimen Type: Kidney tissue
Supplies: Pathology Packaging Kit (T554)
Container/Tube: Formalin-fixed, paraffin-embedded tissue block
Additional Information: Do not send fixed tissue slides. Testing can only be done on paraffin-embedded tissue blocks.
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Kidney Transplant Test Request
-Renal Diagnostics Test Request (T830)
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
See Specimen Required
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Fixed tissue slides Wet/frozen tissue Cytological smears Non-formalin fixed tissue Nonparaffin embedded tissue | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Special | Ambient (preferred) | ||
| Refrigerated | |||
Useful For
Suggests clinical disorders or settings where the test may be helpful
Identification of antigen in membranous nephropathy
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Requests for this test are reviewed by a Mayo Clinic renal pathologist prior to testing. After review of the submitted pathology report, electron microscopy images, phospholipase A2 receptor (PLA2R) staining results, and paraffin block, testing will proceed. If PLA2R results are not available, the pathologist may contact the ordering healthcare professional for the results or for additional specimen (frozen material/slides) to conduct the studies at Mayo Clinic Laboratories.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Membranous nephropathy (MN) is an autoimmune disease and a common cause of nephrotic syndrome in adults. MN results from glomerular accumulation of antigen-antibody complexes along the subepithelial region of the glomerular basement membranes. A series of novel antigens have recently been identified, and many of these antigen-associated MN have distinct clinical and pathologic findings as well as outcomes. This assay is intended to identify the antigens associated with MN using laser microdissection of MN glomeruli followed by mass spectrometry. The panel of MN antigens includes CNTN1, EXT1, EXT2, FAT1, HTRA1, NCAM1, NDNF, NELL1, PCDH7, PCSK6, PLA2R, SEMA3B, and THSD7A.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
An interpretive report will be provided.
Interpretation
Provides information to assist in interpretation of the test results
For results with a detected peptide profile, a description will be provided. The interpretation will include a diagnosis supported by the findings and a clinical reference. A simple description will be given for results that have no peptides detected or insufficient glomeruli.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
No significant cautionary statements
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Sethi S, Madden B. Mapping antigens of membranous nephropathy: almost there. Kidney Int. 2023;103(3):469-472
2. Rovin BH, Adler SG, Barratt J, et al. Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases. Kidney Int. 2021;100(4):753-779
3. Sethi S. Membranous nephropathy: a single disease or a pattern of injury resulting from different diseases. Clin Kidney J. 2021;14(10):2166-2169
4. Bobart SA, Tehranian S, Sethi S, et al. A target antigen-based approach to the classification of membranous nephropathy. Mayo Clin Proc. 2021;96(3):577-591
5. Ravindran A, Casal Moura M, Fervenza FC, et al. In patients with membranous lupus nephritis, exostosin-positivity and exostosin-negativity represent two different phenotypes. J Am Soc Nephrol. 2021;32(3):695-706
Method Description
Describes how the test is performed and provides a method-specific reference
Affected areas are removed from paraffin-embedded tissues by laser microdissection. Protein digestion is performed, followed by liquid chromatography tandem mass spectrometry.(Unpublished Mayo method)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Friday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
82542
88380
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| MSMN | MN Target Antigen ID, LC MS, Ts | 106784-2 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 620789 | Interpretation | 59465-5 |
| 620790 | Participated in the Interpretation | No LOINC Needed |
| 620791 | Report electronically signed by | 19139-5 |
| 620792 | Material Received | 81178-6 |
| 620793 | Disclaimer | 62364-5 |
| 620794 | Case Number | 80398-1 |
| 620795 | Gross Description | 22634-0 |
| 620796 | Addendum | 35265-8 |