RE: Re: kidney biopsy findings in a young lady 1 minutes ago

As pointed out by Dr. Fogo the sampling for frozen IF is not really adequate for any interpretation. This might be a concealed monoclonal gammopath...

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RE: Elevated of B2-microglobulin in dialysis patients 7 minutes ago

I cannot imagine a situation where monitoring serum Beta2microglobulin levels in patients on PD for therapy of ESKD as a guide to management decisi...

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RE: Elevated of B2-microglobulin in dialysis patients 14 minutes ago

Additionally, you can check these articles: Impact change in serum beta microglobulin by combination therapy of peritoneal dialysis and hemodialy...

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RE: Elevated of B2-microglobulin in dialysis patients 23 minutes ago

Regarding PD Maruyama etal,in a large scale registery,found that serum B2M contributes tenuous but significantly to worse outcome and residual ki...

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RE: Elevated of B2-microglobulin in dialysis patients 1 hour ago

Greetings Dr Rosales Thank you very much for your reply, Regards, ------------------------------ Ahmed Yassin MD, FASN Saudi German Hospit...

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RE: Elevated of B2-microglobulin in dialysis patients 1 hour ago

I think B2-microglobulin could be considered in PD where middle molecules are dealt with, Regards, ------------------------------ Ahmed Yassin ...

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RE: Re: kidney biopsy findings in a young lady 3 hours ago

Paraffin IF can be useful when the specimen for usual frozen IF is unsatisfactory. ------------------------------ Agnes Fogo Professor Vanderbilt...

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RE: Elevated of B2-microglobulin in dialysis patients 4 hours ago

Thanks. Very interesting .The Chilean experience is vastly different from the USA where hemofiltration is seldom used and routine serum B2 microglo...

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RE: Elevated of B2-microglobulin in dialysis patients 5 hours ago

Greetings Dr. Yassin, I can comment on aspects of our clinical practice. In our center, we used B2M regularly (every 3 months) to monitor efficien...

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RE: Case of SLN normal dsDNA high SSA/SSB 6 hours ago

Dr. Vishnepolsky: Thanks for the additional information.Can you please post serial C3/C4 values going as far back as possible (at least since the b...

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RE: Re: kidney biopsy findings in a young lady 7 hours ago

Thank you Dr Fogo. What's the role of paraffin IF in the setting of possible LN ? ------------------------------ [Sriram] [Sriperumbuduri] [MBBS...

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RE: Re: kidney biopsy findings in a young lady 7 hours ago

Thank you Dr Glassock ------------------------------ [Sriram] [Sriperumbuduri] [MBBS FASN] [Assistant Professor in Nephrology] [Virginia Commonwe...

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RE: Re: kidney biopsy findings in a young lady 7 hours ago

Thank you Dr Nauman Any thoughts on the pathologist impression ? ------------------------------ [Sriram] [Sriperumbuduri] [MBBS FASN] [Assista...

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RE: Aspergillosis in resistant ANCA associated GN 8 hours ago

Very complicated case and a situation where advice on Communities site may not be applicable, since decision making requires consideration of so ma...

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Elevated of B2-microglobulin in dialysis patients 10 hours ago

Dear respected Kindly,what is your experience regarding elevated serum B2-microglobulin in dialysis patients? ------------------------------ A...

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Aspergillosis in resistant ANCA associated GN 11 hours ago

A very active (skiing and racing exotic cars) 90 Y.O M presented for re-evaluation of aortic valve after TAVR and had AKI when we were consulted. H...

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Elevated of B2-microglobulin in dialysis patients 11 hours ago

Dear respected Kindly ,what is your experience with dialysis patients with high B2-microglobulin? Regards, ------------------------------ Ahm...

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RE: Case of SLN normal dsDNA high SSA/SSB 17 hours ago

@K.K. Venkat she had controlled disease for 15 years until IS has been progressively decreased due to pts symptoms and kind of blossomed into curre...

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RE: Steroid dependent FSGS with "tip lesion" 18 hours ago

I don't think the 'tip lesion" characterization means a great deal in terms of therapy or prognosis . This course can often be seen with the NOS va...

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Steroid dependent FSGS with "tip lesion" 19 hours ago

Dear ASN members I would like to discuss an interesting case with you and request your valuable input. I have a 57 years old male with PMH of w...

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RE: Case of SLN normal dsDNA high SSA/SSB 21 hours ago

The dialogue in this thread has been very fruitful as it has exposed an area of deep controversy in management of LN- how to use serological "indic...

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RE: Case of SLN normal dsDNA high SSA/SSB 22 hours ago

We have a difference of opinion on this issue. Not easily resolved, but the recent paper from Italy tends to support my argument even if low serum ...

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RE: Case of SLN normal dsDNA high SSA/SSB 23 hours ago

The key question in this patient is whether hypocomplementemia is worsening progressively, or llow but stable. If over her long-term follow-up, hyp...

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RE: primary Membranous nephropathy and HBV infection 1 day ago

All good points. HBV infection might be acting as an "adjuvant" like COVID. I am still concerned about giving RTX to a patient kniwn to be infected...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

All good points- I am putting emphasis on the low complement and the likely inadequate intensity of therapy with MMF. If blood MPA levels are below...

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RE: Renal thrombotic microangiopathy 1 day ago

Dr. Christian Kuhn: Can you please post an update on this patient --------------------------------- Alaa Nabih Abdalla nephrology fellow Egypt --...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

This case is complicated but IMO Dr Venkat makes a very important broad point: anytime renal disease--esp proteinuria-- worsens five, ten, fifteen ...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

Such cases of low serum C3/C4 in LN with no histological activity on KB must be uncommon. Do you have any literature citations that show how common...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

There are cases of LN which are serologically persistently active without active inflammation. Increasing SCr and proteinuria can be the result of ...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

Isn't a low C3/C4, rising proteinuria and declining eGFR sufficient evidence of disease "activity" but a urine sediment exam is certainly appropria...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

Is the urine sediment active? Are C3 and C4 on a downward trend? Before subjecting this 74-year-old patient who has already had one opportunistic i...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

Dr. Abdalla. Your concerns about worsening proteinuria and declining kidney function are quite appropriate. The threshold for rebiopsy of patients ...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

pt does not have APS, platelets normal It seems like all roads lead to Vitamin R and her insurance seems to work only on Thursdays will need to s...

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RE: primary Membranous nephropathy and HBV infection 1 day ago

Dear Pr. Glassock, the model system according to which HBV therapy (without the use of immunosuppressive drugs) induces PLA2R1-MN remission, would ...

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RE: Re: kidney biopsy findings in a young lady 1 day ago

Its very odd, but they haven't described the intensity of staining in their report. ------------------------------ [Sriram] [Sriperumbuduri...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

Im not convinced a repeat biopsy would help but she seems to be getting worse despite MMF albeit at low dose I would like to escalate therapy ...

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RE: Re: kidney biopsy findings in a young lady 2 days ago

The IF was done on glomeruli with extensive or global sclerosis so negative result does not help. The deposits by EM in multiple locations suggests...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

Worsening renal function and worsening proteinuria may indicate endothelial injury ..she has anemia and we don't know platlet count ..may be thromb...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

What features in her clinical and laboratory tests makes you think of a superimposed TMA? Renal limited TMA (wotput peripheral manifestations) is f...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

Renal biopsy was 1 year back --------------------------------- Alaa Nabih Abdalla nephrology fellow Egypt ---------------------------------

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

The pathology does not suggest a TMA, but an evaluation for anti phospholipid antibody is reasonable . Just an opinion, -------------------------...

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RE: Re: kidney biopsy findings in a young lady 2 days ago

What is the staining intensity of C3 and IgG. Any Paraffin IF done after Pronase digestion. ? ------------------------------ Richard Glassock MD,...

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RE: Re: kidney biopsy findings in a young lady 2 days ago

What was impression of Histopathologist. There is not much proliferation in intact gloms but to me it seems it is Primary/Idiopathic Immune Complex...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

Any thrombocytopenia ?? TMA ..APS should be excluded --------------------------------- Alaa Nabih Abdalla nephrology fellow Egypt ---------------...

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Re: kidney biopsy findings in a young lady 2 days ago

Hi everyone, I wanted to discuss this patient who was referred for advanced CKD 4 Young lady in her 20s with HTN since the beginning of this y...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

My impression of this case is that it is one dominated by SS manifestations, not SLE, and the dose of MMF tolerated is inadequate to prevent furthe...

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RE: primary Membranous nephropathy and HBV infection 2 days ago

Thanks Dr Awais for the article, couldn't get access to full manuscript but found another publication from Chinese group supporting the idea that a...

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RE: primary Membranous nephropathy and HBV infection 2 days ago

This case, and others like it, raise the intriguing question of whether HBV infection itself is a driver of the Autoimmune phenomenon of anti-PLA2R...

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Case of SLN normal dsDNA high SSA/SSB 2 days ago

Im taking over a case of 74yo woman and hope to get some opinions from the community. Pt has a diagnosis on SLE since 1996 presented as rash and wa...

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RE: NELL-1 positive membranous 2 days ago

Sorry, Dr. Glassock it was misplaced Mawya Shocair MD

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