RE: IgAN With Crescents 25 minutes ago

MRI /genetic panel pending insurance authorization Dr.Glassock --------------------------------- Pooja Tanjavour MD Rch Cucamonga CA (909) 631-...

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Membranous nephropathy 34 minutes ago

I recently saw a 56-year-old African-American patient in my clinic in consultation. He has a 20-year history of membranous nephropathy having been ...

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RE: Diagnostic dilemma/ LCAT??? 1 hour ago

Many thanks Dr. Schwartz. Rare disease with not much available for therapy. Prognosis very poor. ------------------------------ Richard Glassock...

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RE: IgAN With Crescents 1 hour ago

I still do not understand the complicating liver disease- is it Hemachromatosis or not. ? I think you have to treat the presemed crescentic IgAN wi...

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RE: IgAN With Crescents 2 hours ago

Hello all This patient complained of blurry vision after taking 1 week of cellcept . Cellcept discontinued. Steroids dose reduced . Ophthalmology...

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RE: Should I continue treatment 2 hours ago

remains positive after several treatments. ------------------------------ Robert Hillyer MD Metropolitan Nephrologists Grosse Pointe Park MI (58...

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RE: Should I continue treatment 2 hours ago

I was informed by Nephropath that digestion of paraffin block often obliterates the antiGBM antibodies on the specimens. Serum was positive for ant...

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RE: Should I continue treatment 2 hours ago

I agree with Dr. Rodby. I do not know what to make of the lack of linear IgG on Pronase digested IHC of paraffin embedded specimens, if indeed Pron...

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RE: Should I continue treatment 2 hours ago

I will assume double positive ANCA antiGBM related crescentic GN. But from paraffin block there was no linear IgG associated with the crescents? ...

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Should I continue treatment 3 hours ago

Patient is an 79 year old female with history of moderate obesity, DM type II, and hypertension. No previous renal disease. creatinine 1.1 June 202...

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RE: thrombocytopenia 4 hours ago

PD may be a good alternative --------------------------------- Dr. Hormaz Dastoor. MD, MSc, FASN Divisional Head of Nephrology Sheikh Shakhbout ...

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RE: thrombocytopenia 5 hours ago

Any unusual clotting observed, such as in dialyzer?Thus might be HIT..Can your measure anti%-PF 4 antibodies?. Azswithch to a nin-heparin anticoagu...

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RE: Managing severe hypertension in outpatient settings 5 hours ago

Thank you so much Dr. Rodby and Dr. Glassock for your feedback. Appreciate it. I agree, it's a dilemma to decide whether an asymptomatic patient wi...

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RE: Newly Diagnosed Anca Vascultis 5 hours ago

Classical APSGN does not require continued infection for development of disease. Treatment of the infection has a minimal effect on severity of dis...

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RE: thrombocytopenia 5 hours ago

Any procedures or formal clotting time measurements that can give you some idea about how well he clots? ------------------------------ K.K. Venk...

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RE: Diagnostic dilemma/ LCAT??? 6 hours ago

Here are four papers (original - old - new - newest) on LCAT deficiency and the kidney. ------------------------------ John Schwartz MD Dall...

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RE: thrombocytopenia 7 hours ago

Thrombocytopenia can be an immune side effect of polysulfone membranes. If you haven't done so, maybe change to a cellulose triacetate dialyzer and...

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RE: Refractory membranous Nephropathy 8 hours ago

Thanks dr dastoor . Keep us updated It’s great opportunity for me to learn with you in this complex case with expert guidance of prof glassock and...

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RE: Newly Diagnosed Anca Vascultis 8 hours ago

Thanks Dr Aledan I agree I think it would help guide management ct And we would miss things like pulmonary nodule ( humble opinion) -------------...

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RE: Newly Diagnosed Anca Vascultis 8 hours ago

Thanks prof glassock . You are the king of GN🙏🏼🙏🏼🙏🏼. Appreciate your input and guidance Is it correct to say the ASGN should recover with in...

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RE: Serum Ig A Level In Ig A Nephropathy / Vasculitis 11 hours ago

As stated above , no well standardized, FDA or EMA approve tests for serum gdIgA levels are commercially available . Research grade testing is avai...

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RE: Newly Diagnosed Anca Vascultis 11 hours ago

Dr. Soobadar- it is common practice to perform PLEX if the plasma cryoglobulins very high (e.g. > 5% CryoCrit) particularly if symptoms and signs o...

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RE: Serum Ig A Level In Ig A Nephropathy / Vasculitis 11 hours ago

The km55 is a biopsy staining and help in differentiation of IgAN in which there is mucosal derived IgA (2-3+) from CLD where there is systemic der...

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RE: thrombocytopenia 11 hours ago

While there are no formal guidelines establishing a strict minimum platelet threshold for safe AV fistula or graft needling in hemodialysis patient...

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RE: Newly Diagnosed Anca Vascultis 12 hours ago

Pulmonary involvements have been shown to be in two-thirds of patients with newly diagnosed ANCA associated vasculitis so imaging modalities is man...

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RE: Refractory membranous Nephropathy 15 hours ago

I do not think so, unless a rare dual antibody MN can be documented. Or that the AntiPLA2R antibody level is really > 2RU/ml. By ELISA. If she has ...

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RE: Refractory membranous Nephropathy 17 hours ago

Dr. Glassock: Is switching to the Ponticelli regime an option in this patient? ------------------------------ K.K. Venkat MD Troy MI (248) 420 77...

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RE: Newly Diagnosed Anca Vascultis 21 hours ago

Dr- Soobabar - we usually do not do an immediate kidney biopsy in patients with APSGN snd elevated ASLOT and low C3 with normal C4 unless RPGN is p...

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RE: Refractory membranous Nephropathy 21 hours ago

Drs. Dastoor and Aledan- i know of know currently active trials of OBI, Daratumumzb , anti-April/BAFF or other agents in patients with anti-PL...

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RE: Diagnostic dilemma/ LCAT??? 21 hours ago

Sorry - the trial (NCT#04737720 ) being conducted at the NIH Clinical Center Only Other trials are in progress for HuR -LCAT in CV disease (NCT ...

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thrombocytopenia 1 day ago

I have a 29 year old Black male with ESRD on hemodialysis. ESRD secondary to obstructive uropathy. He had congenital malformation of his urinary tr...

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RE: Refractory membranous Nephropathy 1 day ago

Interesting discussions! I think similar to ABMR where there is negative DSA and negative C4D and just MVI on biopsy ans we treat the biopsy findi...

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RE: Newly Diagnosed Anca Vascultis 1 day ago

In regards to your question, why can we not do a routine CXR and look for interstitial infiltrates , especially if there is no hemoptysis or dyspne...

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RE: diagnosis? 1 day ago

Good question, but in this case I do not think that urine pH will influence the choice of KCl or K Citrate as the form of K given to replace ongoin...

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RE: Refractory membranous Nephropathy 1 day ago

Dr. Dastoor- thanks for your comments. We still have a lot to learn about MN and this patient exemplifies our ignorance. A paper from the Bergamo, ...

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RE: diagnosis? 1 day ago

@John Asplin We have a lot of tests and workup done on this patient.. it's unfortunate we don't have a simple urine pH , to guide K therapy !! --...

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RE: Refractory membranous Nephropathy 1 day ago

Thanks Dr. Soobadar for your very insightful comments . I do agree that the changes in GBM could be responsible , along with the podocyte foot pr...

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RE: Refractory membranous Nephropathy 1 day ago

Correction Cyclops or euro lupus dose --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Refractory membranous Nephropathy 1 day ago

Thanks Dr dastoor, I apologies I thought kidney biopsy was negative for plar2. Can you send sample from paraffin block ? I think if you get tissu...

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RE: diagnosis? 1 day ago

Drs. Rodby and Whittier. Is Nephrocalcinosis a contraindication. For kidney biopsy.? If not, would you do a kidney biopsy in this patient fir diagn...

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RE: Diagnostic dilemma/ LCAT??? 1 day ago

These test and genetics are not available in Pakistan , is there any way we can enroll him in the trial ? Yahoo Mail: Search, organise, conquer

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RE: Diagnostic dilemma/ LCAT??? 1 day ago

Sir can u tell me a little about this trial? Yahoo Mail: Search, organise, conquer

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RE: diagnosis? 1 day ago

Thanks so much Yahoo Mail: Search, organise, conquer

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RE: Refractory membranous Nephropathy 1 day ago

A key aspect of this case are the quantitive results of Anti-PLA2R antibody testing by the ELISA method-" if the values are. <2RU /ml she is in a c...

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RE: diagnosis? 1 day ago

Here is a lovely paper by the legendary Fred Coe on secondary hyperparathyroidism in hypercalciuria from 50 years ago. The second paper by Maartje...

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RE: Refractory membranous Nephropathy 1 day ago

@Richard Glassock Dr. Glassock, would you expect the remodeling of the GBM to cause diffuse foot process effacement? ---------------------------...

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RE: Refractory membranous Nephropathy 1 day ago

I agree with your hypothesis as well, and the biopsy on EM does show extensive remodelling as you suggest . I don't have the levels of antiPlA2R ...

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RE: Refractory membranous Nephropathy 1 day ago

An alternate hypothesis, which I favor , is that antibody (and antigen) independent remodeling of GBM structure and function during early MN accoun...

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RE: Refractory membranous Nephropathy 1 day ago

Now I understand. You believe that anti-CD20?therapy should be based on PLA2R antigen expression in the kidney. I know of no evidence that supports...

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RE: diagnosis? 1 day ago

Thanku so much for your valuable comment. Yahoo Mail: Search, organise, conquer

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