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Simplified diagnostic algorithm. In patients with PLA2R-Ab but with unusual presentation or deteriorating renal function or resistant to IS agents, a kidney biopsy is indicated (+); it is not mandatory in the other cases (−). *An immunofluorescence test for the detection of circulating anti-THSD7A antibodies is available but as yet there is no consensus on whether a kidney biopsy should be performed or not in case of positive serology.
