RE: a case of TMA 6 minutes ago

Update: She required 2 sessions of dialysis 29/9 and 30/9 for oliguria, Cr up to 650 acute rise and hypervolemia, at that time she was intubated a...

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Refractory thrombocytopenia in SLE patient 20 minutes ago

Hi everyone, I'm reaching out for some help with a challenging case. We have a 41-year-old woman with SLE who's really struggling with severe thro...

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RE: SLE 2 hours ago

Hit them hard and fast .... Steroids , MMY/CYC plus belulimab for best outcomes --------------------------------- Dr. Hormaz Dastoor. MD, FASN Ne...

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RE: SLE 2 hours ago

Hit them hard and fast .... Steroids , MMY/CYC plus belulimab for best outcomes --------------------------------- Dr. Hormaz Dastoor. MD, FASN Ne...

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RE: SLE 4 hours ago

Interesting findings, not entirely unexpected. Now what therapy will be optimal? Dual with MMF and steroids; Dual EuroLupus, or Triple with either ...

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RE: SLE 5 hours ago

I appreciate your valuable contributions to the discussion in this case Dr. Glasscock and all other physicians in the group. Preliminary result...

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RE: Iptacopan For IC- MPGN 11 hours ago

Dr Rodby and Dr Fogo Thank you both for the clarifications of monoclonality vs Mono-typicality. The fog si finally lifting. -------...

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RE: Iptacopan For IC- MPGN 11 hours ago

monotypic vs monoclonal - "a rose is a rose is a rose" (Gertrude Stein, 1913.) Literary essentialism. The name evoke an image of common knowledge ...

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RE: Iptacopan For IC- MPGN 12 hours ago

This certainly is a complex topic. To me, these new findings would explain why a circulating monoclonal protein may not be found, why bone marrow d...

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RE: Iptacopan For IC- MPGN 12 hours ago

Here is the link https://nam04.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.kidney-international.org%2Farticle%2FS0085-2538&data=05%7C...

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RE: Iptacopan For IC- MPGN 12 hours ago

"Monoclonal indicates a population of cells (like antibodies) that originates from a single cell or ancestor cell, meaning they are genetically ide...

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RE: SLE 12 hours ago

The strong consensus is that a kidney biopsy is needed in this case, but no consensus has emerged as to what category of lesions will be encountere...

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RE: Atrasentan experience and first thoughts 13 hours ago

But the FDA has given accelerated approval for use of Atrasentan in IgA N for reducing proteinuria. No adverse liver toxicity events. Awaiting publ...

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RE: Atrasentan experience and first thoughts 17 hours ago

Endothelin receptor blockers decrease blood pressure in patients with hypertension and reduce albuminuria in patients with diabetic nephropathy and...

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RE: Iptacopan For IC- MPGN 17 hours ago

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RE: Iptacopan For IC- MPGN 18 hours ago

This paper has thrown a real wrench into the onconephrology community. Untreated PGMID does not typically fare well While clones are often not ...

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RE: SLE 18 hours ago

While I think this patient needs a renal biopsy I will be surprised if this is a 3 or 4 with a negative urine dipstick for blood. --------------...

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RE: Iptacopan For IC- MPGN 18 hours ago

Although what has been called PGMID has often been thought to be an MGRS, because it stains in a clonal fashion with the antibodies used for diagno...

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RE: Iptacopan For IC- MPGN 18 hours ago

Thanks for the nice review and references ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ---------------...

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RE: SLE - When To Stop Immunosuppressives 18 hours ago

The 3 previous patients did show complete depletion of CD19. However , my query is for this current patient , who just had a repeat biopsy . Cli...

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RE: SLE 20 hours ago

Mesangial ICs-depositions activate mesangial cells leading to the release of inflammatory cytokines, complement activation (particularly C3), the i...

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RE: Iptacopan For IC- MPGN 20 hours ago

Yes, this is my approach. It Works ------------------------------ Antonio Almeida MD, PhD Salvador-Bahia 55-71-981313969 -----------------------...

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RE: SLE 20 hours ago

Agreed. Some sources point to more than 3 RNC per HPF. However, I have had the experience that at low level hematuria, one may need to do 2 to 3 ex...

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RE: Iptacopan For IC- MPGN 20 hours ago

Agree with Dr. Glassock that both C3G and IC-MPGN can shift phenotype because they shared complement dysregulation (nephritic factoid and genetic v...

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RE: SLE 21 hours ago

Somewhere- around 5 RBC per HPF. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------...

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RE: SLE 21 hours ago

If one were to compare the dipstick to a good microscopic count of RBC per HPF, at what level of RBC per HPF would the dipstick show trace hematuri...

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RE: SLE 23 hours ago

Dr. Dastoor. Thanks for your comment. In IgA N there is a high degree of correlation between the degree of hematuria in IgAN andM1, EI and C1/2 les...

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RE: SLE - When To Stop Immunosuppressives 23 hours ago

Thanks- did these three patients also show full depletion of CD19 B cells after CART cell therapy? ------------------------------ Richard Glassoc...

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RE: SLE 1 day ago

Thank you, Dr. Venkat. Dipstick was negative for blood ------------------------------ Abdeen Farah Musa MD MD BayCare Medical Group Nephrology (S...

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RE: SLE 1 day ago

Thank you very much for your input and contribution. I want to give you some update in this case: Kidney biopsy was done yesterday, result is pe...

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RE: Iptacopan For IC- MPGN 1 day ago

@dr. Glassock. Is it possible to have the reverse ie C3 transforming to IC- MPGN Have attached a report on our 7th patient to start Pegcetacoplan ...

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RE: SLE - When To Stop Immunosuppressives 1 day ago

This is the final report on the biopsy. There are still deposits on the EM . Would agree with continuing MMF . But any role for Cart -----------...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 1 day ago

In terms of treating IgAN in the native kidney, the non Chinese RCT cited by Dr. Rubin(and evaluated by KDIGO ) were all small and underpowered and...

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RE: Atrasentan experience and first thoughts 1 day ago

Dr. Dastoor thanks that was exactly the poster. Unfortunately as I already said the MEST-C score in question is not (in my opinion) very valid to...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 1 day ago

@Richard Glassock The literature cited by Dr. Glassock is all superb animal data (see attached) which, to my knowledge has not translated into hu...

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RE: Atrasentan experience and first thoughts 1 day ago

Good point. We need more data to support this view. What holds for Atrasentan +RASi probably also holds for Sparsentan, but I doubt that we will se...

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RE: Atrasentan experience and first thoughts 1 day ago

I was able to locate the poster as suggested by Dr. Venturelli...looking at uPCR responses in relation to the MESTC scores , it is interesting to n...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 1 day ago

The excellent studies of non immunosuppressive actions of Rodriguez-Iturbe and colleagues performed decades age are often forgotten. These experime...

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RE: Iptacopan For IC- MPGN 1 day ago

According to the literature, genetic testing , C3NeF and AH50/CH50 do not reliably distinguish C3GN and IC-MPGN from each other. After excluding an...

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RE: Iptacopan For IC- MPGN 1 day ago

In the states, Insurance and health conglomerate providers can decide not to provide a test, a service, a treatment as part of their duty to the in...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 1 day ago

@Miguel Uriol Rivera It must be the beautiful Malaga, its gorgeous weather, outstanding food and wines that makes your spirits so positive. The f...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 2 days ago

Dear Mario, Thank you for your thoughtful note. I agree that renal-specific antifibrotic evidence for MMF is limited. My point was simply that MMF...

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RE: Potential donor with mild bilateral increased density of medullary pyramids 2 days ago

Hypercalciuria, urolthiasis and possible nephrocalcinosis would be enough for me exclude this donor. Other opinions welcome. -------------------...

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Potential donor with mild bilateral increased density of medullary pyramids 2 days ago

I would appreciate the community input on the following donor candidate case: 37-year-old white female with no significant past medical history wh...

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RE: Atrasentan experience and first thoughts 2 days ago

Both Atrasentan + RASi and Sparsentan have now been shown to have "anti-inflammatory " activity in IgAN. Exactly where these agents will be positio...

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RE: Membranous nephropathy 2 days ago

All of the anti-PLA2R tests X are by IFA, not ELISA. Do you not have ELISA available? . Only one test was positive by IFA and no PKA2R testing in t...

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RE: Membranous nephropathy 2 days ago

Need to verify few things first. Surprise that casts did not stain for albumin !!, yes albumin in the 3s with such proteinuria can raise suspicion ...

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RE: Iptacopan For IC- MPGN 2 days ago

Thank you, I have contacted them . However we are forbidden to use drug samples or provide medications free - of cost (FOc) under a Medical Assista...

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RE: Atrasentan experience and first thoughts 2 days ago

Just to give a 4 week follow up , after an initial improvement in eGFR from 34 to 31 ml/min the eGFR at 4 weeks is 33 ml/min The uPCR has shown a ...

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RE: Iptacopan For IC- MPGN 2 days ago

There is clinical trial going on with Iptacopan in icmpgn You can contact Novartis Our site is pRt on going trial If i can help connect with me at ...

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