Abstract
Primary membranous nephropathy (PMN) increases venous thromboembolism (VTE) risk. This study investigated the relationship between anti-phospholipase A2 receptor (PLA2R) antibody status and coagulation profiles via thromboelastography (TEG) in PMN patients. In this retrospective study, 53 PMN patients were stratified by anti-PLA2R antibody status. Thromboelastography parameters, including reaction time (R), clot kinetics (K), maximum amplitude (MA), coagulation index (CI), alpha angle (angle), and lysis at 30 minutes (LY30), and clinical outcomes were compared. Among the participants, 58.5% were anti-PLA2R-positive. All five thrombotic events (9.4% of cohort) occurred in seropositive patients, though this was not statistically significant (16.1% vs. 0%, p = 0.13). TEG profiles indicated hypercoagulability in anti-PLA2R-positive patients, showing significantly shorter R and K times, higher MA, greater CI, larger angle, and elevated LY30 (all p < 0.05). Anti-PLA2R-positive PMN patients demonstrate a hypercoagulable state on TEG compared to seronegative patients. Thrombotic events were only observed in the seropositive group, but the small event number precludes definitive conclusions. These results suggest a link between anti-PLA2R antibodies and coagulation abnormalities, warranting further large-scale prospective studies.