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PLA2R antibody positive membranous glomerulonephropathy associated with psoriasis vulgaris

Sir, Psoriasis is a multisystem, immune‐mediated disorder characterized by inflammatory skin and joint manifestations.1 Comorbidities associated with psoriasis include metabolic syndrome, diabetes mellitus, cardiovascular and cerebrovascular disease. This association is attributed primarily to the chronic inflammatory and oxidative stress contributed by pro inflammatory cytokines such as tumor necrosis factor‐alpha.2 Chronic T cell activation, increased cytokines and immune complex deposition have been reported to cause glomerular injury resulting in focal segmental glomerulosclerosis, IgA nephropathy and membranous glomerular nephropathy.3 Primary membranous glomerulopathy may be associated with circulating autoantibodies against a podocyte transmembrane receptor (PLA2R) which can be isolated from the immune complexes deposited at the glomeruli. Association of membranous glomerular nephropathy, anti‐PLA2R antibodies and psoriasis has been described rarely in the literature.4 We came across two cases of psoriasis vulgaris with associated nephropathy who were found to have concurrent anti‐PLA2R antibodies demonstrated on immunohistochemistry on renal biopsy. Management of their renal disease also resulted in remission of psoriasis.