RE: Membranous nephropathy 10 hours ago

Thank you for the clarification. For those interested, these are the references which support Dr. Glassock's statement: Sethi et al., Kidne...

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RE: Membranous nephropathy 10 hours ago

That is mostly due to NELL1 which was negative in this case. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8...

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RE: Membranous nephropathy 10 hours ago

I was under the impression that, although not a single IgG subclass is reliably specific, IgG1 and IgG2 are the most common isotypes identified in ...

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RE: Membranous nephropathy 10 hours ago

Thanks Vito

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RE: Gross Hematuria 12 hours ago

Any clots in the urine? ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 ------------------------------

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RE: Gross Hematuria 12 hours ago

Its all "nuts" to me! ------------------------------ Michael Emmett MD Chief of Internal Medicine Emeritus Baylor University Medical Center Dalla...

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RE: Gross Hematuria 13 hours ago

Wops - I meant nutcracker syndrome not nutmeg syndrome. Sorry for the typo. ME ------------------------------ Michael Emmett MD Chief of Intern...

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RE: Gross Hematuria 13 hours ago

Is this gross hematuria or pigmenturia (Hb, Mb)? Was this documented by a careful examination of the urine sediment? I thought that the Nutmeg Synd...

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Gross Hematuria 13 hours ago

An internist colleague, David Cohen at Lankenau Hospital in Philadelphia, has asked me to consider the following case and we both would appreciate ...

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RE: IgAN and pregnancy 15 hours ago

that was a nice response to steroids and there is evidence that steroids do have a few years of memory , see attached abstract from Kidney wee...

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RE: Membranous nephropathy 16 hours ago

Since the biopsy was negative for PLA2R and NELL 1 I doubt that staining for IgG subclass is going to help with treatment decision making. There is...

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RE: Membranous nephropathy 16 hours ago

Thanks Dr. Campese for your opinion. Congo red was negative. IgG was positive (3+), subtyping of IgG was not done. ----------------------------...

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RE: IgAN and pregnancy 19 hours ago

How much steroids have been given? I would probably continue her RAASi till pregnancy is confirmed just as Dr Glassock has said but I would also pe...

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RE: Sarcoid assoc Ca stones 19 hours ago

Vit d 1,25 55 pth 45 Ca 10.1 ------------------------------ Jonathan Slater MD Renal & Transplant Associates of New England Longmeadow MA ...

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RE: IgAN and pregnancy 20 hours ago

Thanks for the additional information. The course if steroids was definitely indicated snd her course so far has been satisfactory/ of course, she ...

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RE: IgAN and pregnancy 22 hours ago

She is 36 years in age and not a diabetic. Her BMI is 18.5kg/m2 and her baseline blood pressure is 100-120/60s mmHg. Pre treatment hematuria was 7 ...

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RE: IgAN and pregnancy 23 hours ago

Diffucult problem. Before opining -i need to know her BMI , diabetes status, Oxford MEST-C score, hematuria severity, Blood pressure and eGFR trend...

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IgAN and pregnancy 1 day ago

Dear seniors, I wish to draw on your experience in the management of IgAN in pregnant ladies. My lovely patient was diagnosed with biopsy prove...

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RE: Sarcoid assoc Ca stones 1 day ago

As @John Asplin said "Both what have been referred to as absorptive and renal leak hypercalciuria are treated with thiazides." Part of the point th...

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RE: Membranous nephropathy 1 day ago

Thanks Dr. Garrick for your advice. The duodenal biopsy report is pending. I shall post it as soon as it's available. --------------------------...

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RE: Membranous nephropathy 1 day ago

Understood Thanks Dr. Rodby. ------------------------------ Emilio Venturelli MD Scuola di specializzazione in Nefrologia, Università degli st...

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RE: Membranous nephropathy 1 day ago

The original post had the path, but it was not deidentifed enough so we had that part removed. For what it is worth, I was convinced it was MGN. ...

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RE: Membranous nephropathy 1 day ago

Thanks Dr. Glassock for your advice. ------------------------------ Jaison George MD, MBBS Kollam, India ------------------------------

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RE: Membranous nephropathy 1 day ago

Thanks Dr. Rodby for your advice. ------------------------------ Jaison George MD, MBBS Kollam, India ------------------------------

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RE: Membranous nephropathy 1 day ago

Dr. George, I'm not sure that the information you provided are enough to classify this patient has having membranous nephropathy, can you post a mo...

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RE: Membranous nephropathy 1 day ago

CA 125 is a poor marker of cancer in MN. It can be positive due to hypoalbuminemia, edema, serositis, inflammation. A negative test does not rule o...

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RE: Membranous nephropathy 1 day ago

Hi Do you have the biopsy results back from the duodenal lesion?Thinking about possibility of mantle cell lymphoma of the duodenum, which can lea...

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RE: A 19-Year-Old Male with Frank Hematuria, Proteinuria, and Weak Anti-GBM Positivity 1 day ago

any update on the Renal Bx findings ? ------------------------------ Dr Mohamed Buhary MBBS, CCT, FRCP Consultant Nephrologist Jeddah --------...

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RE: Sarcoid assoc Ca stones 2 days ago

Dr. Slater - can you also let us know what the repeat 1,25 dihydroxy Vitamin D level showed.? ------------------------------ Richard Glassock MD,...

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RE: Membranous nephropathy 2 days ago

Steroids alone are ineffective in Primary MN, with or without antiPLA2 R antibody. The utility of serum Biomarkers ( such as CEA or CA125) for canc...

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RE: Membranous nephropathy 2 days ago

The cancer scanning was negative despite high CA125 level, I don't know how specific that level is for an occult malignancy, nor do I know if a PET...

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Membranous nephropathy 2 days ago

Requesting guidance regarding a case of a frail 72 year old lady with a history of type 2 diabetes mellitus and systemic hypertension since 2016, a...

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RE: decision to stop dialysis in patients who lack capacity and family members have divergent views. 2 days ago

Dr Venkat is spot on with the legal position, but who is actually going to go through with the "fight"? This is a problem in the US, especially in ...

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RE: Sarcoid assoc Ca stones 2 days ago

Thanks for the extra information. I agree that a 60 yo man with a creat/kg of 27 is likely an overcollection. Sorry I wasn't clear, when I referr...

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RE: Sarcoid assoc Ca stones 2 days ago

Thx for input PT is male and weighs 60 kg so perhaps not a signif overcollection and even so he has hypercalcuia even if 10-20% overcollection; al...

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RE: decision to stop dialysis in patients who lack capacity and family members have divergent views. 3 days ago

From a US legal perspective (do not know if this will apply in the UK), I got the following from Google AI: "Court decisions generally support doc...

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RE: Sarcoid assoc Ca stones 3 days ago

Dr Slater, Is your patient male or female? What is the patient's weight? A creatinine excretion of 1613 mg doesn't automatically strike me as an ov...

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RE: decision to stop dialysis in patients who lack capacity and family members have divergent views. 3 days ago

Dear colleagues Agree, this is a very difficult situation.We have approached in the past by asking involved family members to come to sit with t...

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RE: decision to stop dialysis in patients who lack capacity and family members have divergent views. 3 days ago

I must agree with Roger's input on this. Even one family member (the 'aggressive one' as he refers to) often prevails. Some years ago, I was forced...

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RE: Patient with recurrent calcium phosphorus stones and medullary sponge kidney, with genetic testing positive for cystinuria 3 days ago

Dr Petersen and colleagues, This is a very instructive case, and I agree with the focus on the calcium phosphate/brushite phenotype and the limite...

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RE: decision to stop dialysis in patients who lack capacity and family members have divergent views. 3 days ago

This is one of the ethical related issues we see often in dialysis units especially among elderly frail patients with loads of co-morbidities. Thi...

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RE: Biopsy dilemma in setting of severe refractory ITP Friday, April 10 @ 11:42 PM

Thanks for your input. I will pass it on. ------------------------------ Deborah Fein MD Nephrologist Pattner and Grodstein MD Englewood NJ 201-5...

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RE: Sarcoid assoc Ca stones Friday, April 10 @ 9:24 PM

Pth 42.5 vit d 25 level 42 Ca 9.1 I am considering doing testing t/ d if he really has incr GI abs hypercalcuria and if we document this t...

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RE: Biopsy dilemma in setting of severe refractory ITP Friday, April 10 @ 9:08 PM

Dr. Leung has already referred to the off-label use of daratumumab (which is already FDA-approved for multiple myeloma) in immune thrombocytopenia ...

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RE: Biopsy dilemma in setting of severe refractory ITP Friday, April 10 @ 6:19 PM

I do not think so but will ask. ------------------------------ Deborah Fein MD Nephrologist Pattner and Grodstein MD Englewood NJ 201-567-0446 --...

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RE: Sarcoid assoc Ca stones Friday, April 10 @ 1:38 PM

I think I would favor a trial of ketoconozole while monitoring urine calcium exterminator rate. Just an opinion not based on evidence. What is the ...

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RE: decision to stop dialysis in patients who lack capacity and family members have divergent views. Friday, April 10 @ 1:31 PM

This problem can be, potentially at least, minimized by a careful explanation to the family members what a "trial of dialysis" really means ,before...

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RE: decision to stop dialysis in patients who lack capacity and family members have divergent views. Friday, April 10 @ 1:07 PM

My only advice in these situations is to say if this were my family member I would not dialyze as putting the patient through dialysis will decreas...

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RE: Biopsy dilemma in setting of severe refractory ITP Friday, April 10 @ 12:25 PM

I was wondering about that. Have your hematologist tried daratumumab to target the CD38 cells. It has been reported to be successful in rituximab r...

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RE: Patient with recurrent calcium phosphorus stones and medullary sponge kidney, with genetic testing positive for cystinuria Friday, April 10 @ 12:04 PM

Dr Peterson, Thank you for posting the 24 hr urine data. I assume the PTH and vit D data you provided are all within the reference range for your l...

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