RE: pr3 +ve is it endocarditis ? 1 hour ago

@Richard Glassock, with all due respect, Claude should be consulting you. ------------------------------ Roger Rodby MD, FASN Professor of Medic...

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RE: Anti-PLA2R antibody +ve MN on a background of malignancy 5 hours ago

There is a increased prevalence of cancer in PLA2R patients but I am not convinced it is pathogenic (See attached) I dont trust PLA2R titer of (...

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RE: C3G Or FSGS 7 hours ago

The degree of C3 staining (occasional, 1-2+ segmental) with some mesangial hypercellularity and the absence of electron dense deposits to me is not...

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RE: C3G Or FSGS 9 hours ago

Please see attached biopsy reports .. Am actually on vacation without a laptop and can't post the biopsy into the body of this message . Thanks ...

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Anti-PLA2R antibody +ve MN on a background of malignancy 9 hours ago

Mr. G.N. is a 74-year-old gentleman with the following past medical history: Peripheral vascular disease (right-sided claudication that did not r...

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RE: C3G Or FSGS 10 hours ago

A difficult case to classify, but in my opinion this is most compatible with a presentation of Primary FSGS, not C3GN. Isolated deposits of C3 have...

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C3G Or FSGS 11 hours ago

Have a 24 year old young prisoner . He presented from the prison in June 2026, with sudden onset of nephrotic syndrome . Initial labs , showed ...

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RE: pr3 +ve is it endocarditis ? 13 hours ago

I agree , despite the cost , under appropriate conditions , i also agree it seems justified . Will be keen to consider this test in the future .. t...

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RE: pr3 +ve is it endocarditis ? 14 hours ago

Dr. Dastoor. Thanks for your clinical perspective on this novel test. My experience is limited (n=1)- where the result made a big difference in man...

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RE: pr3 +ve is it endocarditis ? 16 hours ago

"Occasionally it’s helpful but most of the time It picks up zillions of DNA. Too much background noise, we need to figure out which is the true pat...

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RE: pr3 +ve is it endocarditis ? 16 hours ago

Karius test is proprietary, owned by Karius, Inc. Please see following reference: https://kariusdx.com/resources/press-releases/karius-announce...

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RE: pr3 +ve is it endocarditis ? 19 hours ago

How can you be sure that the kidney function is improving? he is seriously ill and muscle creatinine generation may be impaired . A serum Cystatin ...

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RE: pr3 +ve is it endocarditis ? 21 hours ago

if IE is causing pos ANCa/PR3 POS why is kidney function improving without specific anti-infection treatment , also hypercalcemia is not associated...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 22 hours ago

thanks-given stable eGFR but significant proteinuria/albuminuria-would add low dose TAC and follow trough levels( goal< 5) , FYI probably need to w...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 22 hours ago

yes total protein cr and Acr ------------------------------ Vijayakumar Paramasivam MD Nephrologist Renal and Transplant Associates of the North...

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RE: pr3 +ve is it endocarditis ? 22 hours ago

Bartonella endocarditis can be very difficult to diagnosis and is uniformly " culture negative" . PCR testing is a real advance. Agree - no Immunos...

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RE: pr3 +ve is it endocarditis ? 22 hours ago

Thanks for educational input from everyone --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: pr3 +ve is it endocarditis ? 22 hours ago

I Assume once toe shows vegetation and blood cultures negative then start looking at culture negative endocarditis screen ? ---------------------...

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RE: pr3 +ve is it endocarditis ? 23 hours ago

Patient not on antibiotics . Awaiting cultures Creatinine improving as attached with improving calcium Chloride normal will send value . What are ...

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RE: pr3 +ve is it endocarditis ? 1 day ago

I have used it once to detect a Bartonella endocarditis. A phenomenonal test. Virtually no false positives and false negatives seem to be uncommon....

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RE: pr3 +ve is it endocarditis ? 1 day ago

Dr Venkat, I was going to reference this test but I couldn't think of it... But it is an amazing tool or so I have read! ----------------...

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RE: pr3 +ve is it endocarditis ? 1 day ago

The Karius cell-free microbial DNA test is claimed to detect ~ 1000 microbial DNAs in blood sample. We had a recent case in which our infectious di...

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RE: pr3 +ve is it endocarditis ? 1 day ago

I agree with Dr. Rodby 100%.!!! ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine at UCLA Lag...

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RE: pr3 +ve is it endocarditis ? 1 day ago

Besides blood cultures I would get titers for various organisms such as Bartonella, Coxiella, Gamella, and any other rare culture negative SBE orga...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

@David Wilhelm "Thanks for the response, Roger! This may sound like a stupid question, but can you give an explanation (or provide me a resour...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

Am I missing something? "UPCR showed total protein 347 mg/dL and Cr 81 mg/dL (ratio 4.27). Initial UPCR showed total protein 128 mg/dL and Cr 19 mg...

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RE: pr3 +ve is it endocarditis ? 1 day ago

Dr. Soobadar: What is the SCr trend? Is the patient on antibiotics for presumed endocarditis? If SCr is improving on antibiotics, infection-related...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

"Kudos to biopsy a solitary kidney" thanks DR. Rodby for stimulating me to ask ( remember I have done hundreds of transplant kidney biopsies (solit...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

I am not "against" use of sibeprenlimab (or atacicept) in this case, But this is relatively advanced disease and a T2 lesion would gave excluded th...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

Check serum Gd-IgA1 and APRIL levels if possible to confirm sibeprenlimab pharmacodynamic activity. Check serum IgA, IgG, IgM levels - these ...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

My recommendation is based on personal experience . Ideally you should have seen a response in terms of uPCR reduction by 3 months . In the studie...

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RE: pr3 +ve is it endocarditis ? 1 day ago

Back in the days when PTH assay was in its infancy, biomarkers for PTH excess were in vogue. A nice paper by Palmer in 1974 Annals of Internal Medi...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 1 day ago

Please clarify PCR ? ACR ? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pancreas...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

Thanks for the response! Is your preference for steroids just based on experience alone or are you not yet wanting to use the BAFF/APRIL inhibitors...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

Given my personal experience, I would have preferred to start with oral steroids , unless there are strong contraindications. However , after 3 mo...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

The variation in urine creatinine concentration in a "spot" un timed urine sample tells you virtually nothing about 24 hour urine creatinine excret...

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RE: pr3 +ve is it endocarditis ? 1 day ago

Granulomas in PR3-+ Vasculitis can occasionally lead the hypercalcemia, which is excess 1,25 dihydroxy vitamin D driven, thus iPTH levels should be...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

Appreciate the response, Dr. Glassock! He is not obese. BMI is 30. ------------------------------ David Wilhelm DO Nephrologist Nephrology Consul...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

Albumin in February was 3.0. Current albumin is 3.3. No current edema. He did have some at the time of the initial visit but made improvement with ...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

Thanks for the response, Roger! This may sound like a stupid question, but can you give an explanation (or provide me a resource so I can read more...

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RE: pr3 +ve is it endocarditis ? 1 day ago

Thanks prof glassock Wednesday PET . Outpatient toe requested by id team. Have contacted cardio for inpatient TOE ( hopefully this week) High cal...

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RE: pr3 +ve is it endocarditis ? 1 day ago

The elevated Anti-PR3 is highly likely to be due to Endocarditis. When will you be doing a Trans-esophageal Echocardiograph .? ------------------...

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RE: pr3 +ve is it endocarditis ? 1 day ago

Rf raised 79 (0-14) C3/c4 not back Hiv negative , syphilis negative --------------------------------- Muhammad Soobadar MBChB UK -------------...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

With a solitary kidney at least some of the proteinuria is due to maladaptive capillary hypertension. Too early to tell about beneficial effects of...

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RE: pr3 +ve is it endocarditis ? 1 day ago

What is the serum Rheumatoid Factor Level and the C3 And C4 levels?Is the HIV testing negative,? ------------------------------ Richard Glassock ...

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pr3 +ve is it endocarditis ? 1 day ago

54 MALE Constitutional symptoms ( hx of endocarditis 2023 in the context of TOF/Congenital Heart Disease) feeling unwell since Feb 26 --> 2 st...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

Serum albumin trend? Any edema? Size of right kidney/is it hypertrophied/echogenicity? ------------------------------ K.K. Venkat MD Troy MI (248...

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RE: Hyperfiltration/IgA nephropathy 1 day ago

1) Kudos to biopsy a solitary lkidney 2) Kudos to being aggressive with APRIL inhibitor (started in April btw) 3) This is advanced disease whe...

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Hyperfiltration/IgA nephropathy 2 days ago

I have a patient I would like to present for advice. 57 y.o. male with history of aortic dissection involving left renal artery in 2015 with resu...

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RE: young girl with Chronic TI dz 2 days ago

THanks for mentioning us Roger and Dick! I agree with your thoughts and am interested to test! Tony ------------------------------ Anthony Bleyer...

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