RE: Simple question - EDEMA 3 hours ago

I would withhold all diuretics, including spironolactone, if possible. ------------------------------ Richard Glassock MD, FASN Emeritus Professo...

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RE: recurrent intracerebral hemorrhagic stroke in a young female known case of hypertension VS ANCA associated vasculitis 5 hours ago

Thank you, Dr. Glassock. Given her functional status and active vasculitis, is it appropriate to treat her with rituximab? For your kind opinion...

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RE: Simple question - EDEMA 5 hours ago

Thank u.. I just read the chapter and interesting concepts . Will try to completely stop her diuretics . It does say to consider blocking the. R...

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RE: Treatment of membranous nephropathy with microsherular substructure 6 hours ago

Based on this information I would give hydroxy chloroquine, low dose steroids and MMF. No reason to be super-aggressive with therapy . Hard to say ...

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RE: Biopsy or not to Biopsy 6 hours ago

1. Genetic studies were sent yesterday to rule out fabrys , Alport etc 2. The proteinuria has been present for around a year 3. uACr = 0.49 and u...

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RE: Biopsy or not to Biopsy 7 hours ago

thanks Dr. Glassock-exclude FABRY'S after r/o orthostatic proteinuria-excellent point! ------------------------------ [Mark] [Lerman] [MD,FASN,FA...

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RE: Treatment of membranous nephropathy with microsherular substructure 7 hours ago

complement don elate 2025 at that time c31.13g/l C$ 0.33 g/l ssa+, SSB+( we acn't get levels just positive negative Her plasma albumin was 34 i...

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RE: Lipid Management In Young Patient With Steroid Responsive Do 7 hours ago

Fit and well and slim --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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Lipid Management In Young Patient With Steroid Responsive Do 7 hours ago

Appreciate input 18 year old male kb for nephrotic syndrome - showed minimal change . Cholesterol 7 has gone to 5 remission after 8 weeks ans now ...

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RE: Alveolar haemorrhage in ANCA vasculitis 7 hours ago

Muhammad Soobadar - "@ lerman - not in this case but if acute presentation of pulmonary haemorrhage with haemoptysis but no hypoxemia with multisys...

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RE: Biopsy or not to Biopsy 8 hours ago

Thanks prof glassock --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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IgA nephropathy in a 28 yo 8 hours ago

28 yo old female with proteinuria ( 950 mg ) noted while she was pregnant about 3 years ago with creat normal at 0.9 then / uneventful pregnancy wi...

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RE: Biopsy or not to Biopsy 8 hours ago

I would always consider Fabry's disease when young man presents with isolated proteinuria of undefined duration. Serum Alpha-galactosidase A levels...

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RE: Simple question - EDEMA 9 hours ago

This is very likely "Idiopathic Cyclical Edema" which is made worse or aggravated by diuretic or estrogen therapy. The Chapter on this topic in UpT...

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RE: Biopsy or not to Biopsy 10 hours ago

What is the UACR/ UPCR ratio? For how long has the proteinuria been documented to be present? Any skin or eye changes? What is the Family History f...

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RE: MPGN with IgM, C1q, kappa and lambda, no Immune Complexes 10 hours ago

Thank you, Will ask our pathologist to stain. I also had a feeling that this could be TMA the reason why I sent a functional assay. Somehow I am i...

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RE: MPGN with IgM, C1q, kappa and lambda, no Immune Complexes 10 hours ago

Thank you Dr. Gharib. --------------------------------- Mohammad Atari, M.D. Assistant Professor of Medicine University of Mississippi Medical Cen...

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RE: MPGN with IgM, C1q, kappa and lambda, no Immune Complexes 10 hours ago

Except for the frozen IF , this case looks more like TMA and has some resemblance to TAFRO syndrome. I would stain the bone marrow for reticulin fi...

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RE: MPGN with IgM, C1q, kappa and lambda, no Immune Complexes 11 hours ago

Seems to be chronic infection (fungal or bacterial) that caused hepatic granulomatous disease, infection related MPGD and positive serologies (ANA ...

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RE: DNAJB9-positive fibrillary GN with a distal acidification defect and recurrent calcium stones 11 hours ago

Fibrin polymers deposited along the apical surface of tubular epithelial cells and tubular basement membrane showes trace granular reactivity for c...

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RE: Biopsy or not to Biopsy 11 hours ago

Hi dr dastoor , Humble opinion These cases no right or wrong answer . If being in the police force means he need to get an answer then maybe need ...

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RE: MPGN with IgM, C1q, kappa and lambda, no Immune Complexes 11 hours ago

Thank you, Dr. Glassock, IF on paraffin embedded tissue was done after pronase digestion. Now repeated Bartonella IgG is negative. JAK2 is negativ...

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RE: Alveolar haemorrhage in ANCA vasculitis 11 hours ago

Thanks for very intriguing questions. Eager to know the reply from leaders. ------------------------------ Dr Adarsh Babu MBBS, FRCP, PhD, FASN ...

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RE: Alveolar haemorrhage in ANCA vasculitis 11 hours ago

Thank you He had 2 doses of 1gm each time for Rituximab. He was on Co-trimoxazole prophylaxis We are working him for atypical infection and d...

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Biopsy or not to Biopsy 12 hours ago

Saw a 19 year old boy who came to me as his fourth opinion ( unfortunately , hurt my ego) He works as a policeman , and while starting his job a ...

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Simple question - EDEMA 12 hours ago

Saw a 44 year old lady . She presents with a 3 year history of lower limb edema The edema responds well to Furosemide , but recurs with a ven...

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RE: Refractory membranous Nephropathy 12 hours ago

Jut to give a follow up on this case . The patient has had 2 repeated urine tests , a uPCR which showed around 6 g/g and a 24 hour urine collection...

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RE: Alveolar haemorrhage in ANCA vasculitis 14 hours ago

I agree no plex and escalation of IS Bronchoscopy / beta glucan / galactomananm/aspergillus Is crp / ESR raised ? Compared to falling mpo ? @ pr...

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RE: DNAJB9-positive fibrillary GN with a distal acidification defect and recurrent calcium stones 14 hours ago

I think that the findings in thus case can be fully explained by the concurrence (as observed in case reports in the literature) of Fibrillary GN a...

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RE: Alveolar haemorrhage in ANCA vasculitis 14 hours ago

I agree- no indication for PLEX in this, unless antiGBM Dusease is identified serologically. ------------------------------ Richard Glassock MD, ...

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RE: PhD student interested in diabetic kidney disease research - career development and postdoctoral guidance 16 hours ago

Hello Nick, It's great to "meet" you and to learn about your excitement for kidney research. I'd be happy to share my experience with you. I'm ...

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RE: Alveolar haemorrhage in ANCA vasculitis 17 hours ago

Thank you for sharing this case. I have a few questions: 1. How many doses of rituximab were given in the initial course, and was maintenance ...

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RE: origins of the standard "fishbone" notation for the chem 7? 17 hours ago

From Ai- the "skeleton," "sawhorse," or "fishbone" hand notation appears to be a piece of oral/apprenticeship medical culture that propagated throu...

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RE: DNAJB9-positive fibrillary GN with a distal acidification defect and recurrent calcium stones 19 hours ago

RTX here has data for the fibrillary gn. Am J Kidney Dis . 2013 Oct;62(4):679-90. doi: 10.1053/j.ajkd.2013.03.031. Epub 2013 Jun 4. Long-term k...

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RE: DNAJB9-positive fibrillary GN with a distal acidification defect and recurrent calcium stones 19 hours ago

Reviewed three CTs and three ultrasounds over 15 months, no nephrocalcinosis on any, normal parenchymal echotexture, discrete calculi all 6 mm or s...

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RE: DNAJB9-positive fibrillary GN with a distal acidification defect and recurrent calcium stones 20 hours ago

this is what I found regarding auto- antibodies in RTA - quote from the attached article "The pathophysiological mechanism of dRTA in relatio...

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RE: recurrent intracerebral hemorrhagic stroke in a young female known case of hypertension VS ANCA associated vasculitis 21 hours ago

Thank you, Dr. Lerman, for your reply regarding hydralazine was stopped. Current blood pressure is under control with lisinopril 10 mg and aml...

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RE: recurrent intracerebral hemorrhagic stroke in a young female known case of hypertension VS ANCA associated vasculitis 22 hours ago

I agree with Dr. Venkat. Recurrent intracranial hemorrhage is a very rare complication of Anti-MPO microscopic vasculitus so there is almost no med...

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RE: MPGN with IgM, C1q, kappa and lambda, no Immune Complexes 22 hours ago

Very puzzling case. I have no good explanation for the discrepancies between the frozen IF, paraffin IF and EM findings. Was the paraffin IF perfor...

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RE: recurrent intracerebral hemorrhagic stroke in a young female known case of hypertension VS ANCA associated vasculitis 1 day ago

"My question is how aggressively we should approach the treatment of her ongoing MPO-AAV, especially considering the active cerebral vasculitis and...

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RE: recurrent intracerebral hemorrhagic stroke in a young female known case of hypertension VS ANCA associated vasculitis 1 day ago

has hydralazine been stopped( it should be)? what is BP? what imaging was used to distinguish ICB/STROKE from vasculitis vs hypertension? add RTX a...

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RE: Alveolar haemorrhage in ANCA vasculitis 1 day ago

"Question to the group - Do we consider PLEX in this case at this stage." Plex is not indicated in DAH without hypoxemia. agree with Bronchoscop...

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MPGN with IgM, C1q, kappa and lambda, no Immune Complexes 1 day ago

Good afternoon, I would like to share this case and get some insights. A 38-year-old female with hypertension and opioid use disorder on buprenor...

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Alveolar haemorrhage in ANCA vasculitis 1 day ago

60-year-old man with biopsy-proven MPO-ANCA associated pauci-immune vasculitis involving the ENT tract and kidneys. Initial presentation (June 20...

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PhD student interested in diabetic kidney disease research - career development and postdoctoral guidance 1 day ago

Hello everyone, I wanted to introduce myself to the Basic Science Research community. I am currently a PhD student at Wayne State University, whe...

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origins of the standard "fishbone" notation for the chem 7? 1 day ago

Hoping that a historian of nephrology can help me out of a rabbit hole on this topi. I know the chem 7 was born when the autoanalyzers were invente...

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recurrent intracerebral hemorrhagic stroke in a young female known case of hypertension VS ANCA associated vasculitis 1 day ago

I was recently consulted to evaluate a young female patient in her 40s who was referred by the neurology team for recurrent hypertensive cerebral b...

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One Week Left! - Nephrology Quiz and Questionnaire 1 day ago

Calling all nephrology fellows and program directors-we need your help with the Nephrology Quiz and Questionnaire. Take the quiz today! Each year...

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One Week Left! - Nephrology Quiz and Questionnaire 1 day ago

Reminder: There is one week left to complete the Nephrology Quiz and Questionnaire! Calling all nephrology fellows and program directors-we need ...

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RE: Treatment of membranous nephropathy with microsherular substructure 1 day ago

Interesting case. It would help if you posted the full deidentified kidney biopsy report and one or two EM photomicrographs. We also need a serum a...

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