RE: Anti-PLA2R antibody +ve MN on a background of malignancy 22 minutes ago

Thanks Dr. Lambeau for these fresh and important insight into the connection between PLA2R and Cancer!! ------------------------------ Richard Gl...

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RE: Latent TB and Membranous Nephropathy 30 minutes ago

In the MENTOR trial of RTX vs CsA NEJM) infectious complications were twice as frequent with CsA. My AI consultant (Claude) stTes very clearly that...

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RE: Latent TB and Membranous Nephropathy 52 minutes ago

Thanks dr dastoor for learning experience and sharing your experience @ prof glassock thanks for learning experience Can I ask if there is paper...

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RE: Anti-PLA2R antibody +ve MN on a background of malignancy 56 minutes ago

I would suspect a link between MPN and PLA2R1-MN. PLA2R1 has been proposed as a tumor suppressor gene, and is involved in various types of cancer, ...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

This discussion may be moot- as Felzartamab has no benefits in RTX resistant MN- see Trillini et al KI Reports, 2026 ---------------------------...

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RE: Anti-PLA2R antibody +ve MN on a background of malignancy 1 day ago

I think this is a very reasonable approach, considering the clinical circumstances. Good luck. ------------------------------ Richard Glassock ...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

We do not use CNI for membranous, at least I don't . However at the ERA 2026 , when the Obi trial was presented , the first and main question that ...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

I see-it is all about access, not comparative efficacy and safety.. Do you really think that CNI are safe and effective for MN in an era of biologi...

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RE: Anti-PLA2R antibody +ve MN on a background of malignancy 1 day ago

Dear colleagues, As per the previous discussion, and after reading the article Dr.Rodby suggested, I repeated his anti-PLA2-R level, and decided...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

I agree but the Obi trial should have also been compared to Rituximab. I think it was compared to CNI for 2 reasons 1. Rituximab is not FDA appro...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

How can such a trial of Felzartamab show superiority to OBI-assuming that OBI is approved by the FDA for therapy of MN as a consequence of the MAJE...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

@Richard Glassock could you elaborate why Felzartamab would be a meaningless approval , if OBI was also compared to a CNI. ----------------------...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

In my opinion, CNIs (Tacrolimus or Cyclosporin + or - low dose steroids ) are no longer considered a standard of care for treatment of MN. If one a...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

Thank you, have put in for Obi prior Auth. Have a great weekend. ------------------------------ T. Kaur, MD FACP Nephrologist/HTN/Kidney Stones ...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

Will Felzartamab gain approval for MN from FDA by comparison to a CNI ?. If so . the approval will be meaningless. The comparator will have to be O...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

Regardless of PLA2Ra positive or other. This is an antibody driven disease and therapy is targeting the antibody producing cells. I agree with abov...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

I fully agree with Dr. Rodby- a CR with RTX makes Cancer less likely but either way with NELL1 disease you have to look hard for triggers. Mercury ...

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RE: PLA2R negative Membranous Nephropathy- Management Q 2 days ago

As you know, Nell1 MGN is Cancer, medications, herbals, Hg containing skin creams, lipoic acid, ask about everything... It is often segmental and...

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RE: PLA2R negative Membranous Nephropathy- Management Q 2 days ago

Biopsy is NELL 1 positive. THSD7A negative. Does that change the management? Cancer screen was negative. still Ola to watch he proteinuria a...

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RE: Latent TB and Membranous Nephropathy 2 days ago

Yes Quantiferon is part of screening in our hospital. I do it because , it avoids conflict with the infusion and ID teams who have created the prot...

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RE: Latent TB and Membranous Nephropathy 2 days ago

Thanks Quantiferon is not part of pre rituxan screen in my centre --------------------------------- Muhammad Soobadar MBChB UK ----------------...

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RE: Latent TB and Membranous Nephropathy 2 days ago

YES, especially when steroids are used n conjunction with a CNI. I would definitely avoid any CNI or steroid use in this patient ---------------...

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RE: pr3 +ve is it endocarditis ? 2 days ago

well PTH was not suppressed and urine calcium was borderline high so could be primary HPTX especially since serum phos low. eGFR 65 with creatinine...

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RE: Latent TB and Membranous Nephropathy 2 days ago

Is Cni risk higher than rituxan for latent tb reactivation prof glassock --------------------------------- Muhammad Soobadar MBChB UK ---------...

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RE: Latent TB and Membranous Nephropathy 2 days ago

I would not advise use of a CNI,especially with steroids, for MN in a patient with latent TB. Just an opinion. ------------------------------ Ri...

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RE: pr3 +ve is it endocarditis ? 3 days ago

Prior to cinecalcet --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Latent TB and Membranous Nephropathy 3 days ago

Respiratory MDT Reviewed case Agree TB highly unlikely given reassuring CT, stability of bronchiectasis and only Sx weight loss Given product...

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RE: Latent TB and Membranous Nephropathy 3 days ago

Thanks Dr. Dastoor fir your commentary on this case.. It is not uncommon to see combinations of CNI and RTX used to "speed up" the trajectory towar...

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ASN Loan Mitigation Program 3 days ago

ASN is now accepting applications for the ASN Loan Mitigation Program as a part of its continued efforts to decrease the loan burden of those enter...

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RE: Latent TB and Membranous Nephropathy 3 days ago

Couple of questions 1. Was the Quantiferon checked , because you planned to give Rituximab or because of his symptoms of chronic cough and weight...

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RE: pr3 +ve is it endocarditis ? 3 days ago

Was serum calcium and urine calcium prior to or after cinecalcet? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP E...

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RE: Anti-PLA2R antibody +ve MN on a background of malignancy 3 days ago

I am grateful for your input to help me with this case. The platelets are normal @ Dr.Soobadar. ------------------------------ Safa Now...

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RE: Anti-PLA2R antibody +ve MN on a background of malignancy 3 days ago

If I am not mistaken the malignancy seems to have predated the onset of suspected Membranous Nephroapthy by a relatively long duration. I would con...

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RE: Latent TB and Membranous Nephropathy 3 days ago

Thanks prof glassock He is on treatment dose enoxparin So you would not do PET or bronchoscopy ? CTTAP - -ve Psa negative No breast lump Us...

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RE: Latent TB and Membranous Nephropathy 3 days ago

I would treat with RTX in the absence of any positive screenings for occult cancer .. ------------------------------ Richard Glassock MD, FASN Em...

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RE: Latent TB and Membranous Nephropathy 3 days ago

With a negative tissue PLA2R I see no point in repeating the serum Anti-PLA2R . With the severe NS I would not wait too long before treating with R...

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RE: Latent TB and Membranous Nephropathy 3 days ago

Cannot do thrombospondin --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Latent TB and Membranous Nephropathy 3 days ago

“Ibwoiul repeat tgecdeerumbPLA2R one by ELISA” What do you mean prof glassock --------------------------------- Muhammad Soobadar MBChB UK ----...

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RE: Latent TB and Membranous Nephropathy 3 days ago

Plar 2 negative biopsy Request for nel . They can do either serum or tissue thrombospondin --------------------------------- Muhammad Soobadar M...

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RE: Latent TB and Membranous Nephropathy 3 days ago

I think the TB findings are co-incidental and not causal. This is pretty advanced Dusease. Let's see what the PLA2R is in glomeruli first. I would ...

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RE: pr3 +ve is it endocarditis ? 3 days ago

Calcium 2.91( 2.20-2.60) --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: pr3 +ve is it endocarditis ? 3 days ago

Bilirubin 12(5-21) Ferritin 238 (30-337) Yes have access to measured gfr but not sure how fast it will be done Are you thinking if mgfr low then k...

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RE: pr3 +ve is it endocarditis ? 3 days ago

What was the serum calcium when the PTH was 8? ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medic...

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RE: pr3 +ve is it endocarditis ? 3 days ago

Improving calcium with cinecalcet not fluids 24hr urine for calcium 6.11(2.5-7.5) 24 hr volume 2.74 L Urine calcium 2.23 mmol/L ----------------...

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RE: pr3 +ve is it endocarditis ? 3 days ago

Chloride normal Pth 8 ( 1.5-7.6) Vitamin D 111 mmol/L 1-25 OH pending --------------------------------- Muhammad Soobadar MBChB UK ----------...

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RE: Anti-PLA2R antibody +ve MN on a background of malignancy 3 days ago

Isn't this most likely PLA2R+ MN in a Patient with MDS? The choice of RTX for initial therapy seems quite reasonable, especially in the face of a d...

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RE: Latent TB and Membranous Nephropathy 3 days ago

------------------------------ Muhammad Soobadar MBChB UK ------------------------------ Files Attached DocumentRE: Latent TB and Membranous Nephro...

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Latent TB and Membranous Nephropathy 3 days ago

87M. CKD 4 , TCC bladder, BPH, HTN, AF, Diverticular disease. Bronchiectasis Been under review since April with nephrotic syndrome (oedema starte...

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RE: Anti-PLA2R antibody +ve MN on a background of malignancy 3 days ago

If I were to use ritux I would consult with haematology as alluded by prof rodby first --------------------------------- Muhammad Soobadar MBChB ...

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RE: Anti-PLA2R antibody +ve MN on a background of malignancy 3 days ago

I am not sure I would treat fsgs with normal albumin with IS Same vein here not sure if patient is not nephrotic with MN and has RVT , drug use , ...

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