therapeutic Lovenox dose in an ESRD setting 16 minutes ago

I know I am trying to go thru the eye of the needle. For a patient w. ESRD who can't have warfarin but must have the alternative (Lovenox) for anti...

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RE: Proteinuria and hematuria in 2 siblings 43 minutes ago

I think this sounds consistent with genetic FSGS due to a mild NPHS2 variant. I'm not sure why the genetic report states that there shouldn't be a ...

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RE: Proteinuria and hematuria in 2 siblings 1 hour ago

Mark, very interesting reply and info, We just the Natera genetic test bc it is SO SO So easy to obtain and I cannot remember the last time a pat...

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RE: Proteinuria and hematuria in 2 siblings 2 hours ago

not a genetics expert but FYI my AI consultant says regarding this case-"An occult COL4 abnormality has not been excluded by a negative panel. This...

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RE: Full House/Non Lupus nephropathy 3 hours ago

The other question here is what to do with your younger patient you just inherited. What is her clinical status and what is she receiving? --...

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RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 3 hours ago

I have no experience with this but this is what I find: "Membranous glomerulonephritis (mGN) linked to hepatitis B virus (HBV-MN) can so...

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2026 ASN FIT Bowl 4 hours ago

ASN FIT BOWL Hey, we are 3 fellows of Jefferson Einstein Philadelphia, we are looking for another fellow to participate with us and complete the te...

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RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 6 hours ago

Would you prefer conservative therapy in this case, or go with immunosuppression, go for modified ponticelli? In that regimen, high dose steroids m...

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RE: Full House/Non Lupus nephropathy 10 hours ago

Most large studies have demonstrated great difficulty is separation C3G and "so called " Primary IC-MPGN into discrete "entities". I agree with San...

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RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 10 hours ago

The issue is one of safety of RTX, in the face of continued HBsAg positivity in a patient with HBV infection under therapy with Entacavir. . Do you...

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RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 11 hours ago

With the PLA2R titer and proteinuria more than 8g still, probably falls under the high risk category and would warrant immunosuppression with RTX. ...

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RE: MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 15 hours ago

Dear all!! Thank you all very much for these thoughtful and extremely helpful suggestions. I truly appreciate the time and expertise you have ...

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RE: Rituximab, Membranous Nephropathy, and Isolation in a Prison Setting 16 hours ago

No need for isolation of a patient with MN under therapy with RTX, unless HBV-DNA positive and thus possibly a vector of HBV infection, --------...

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RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 17 hours ago

Active hep b is linked to MN --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 17 hours ago

Active hep is linked to mn then maybe treat hep B first and see and if no improvement maybe kidney biopsy before rituxan ( just a humble opinion ) ...

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Rituximab, Membranous Nephropathy, and Isolation in a Prison Setting 17 hours ago

For a prisoner with membranous nephropathy who is being treated with rituximab, is isolation required solely because the patient received rituximab...

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RE: Proteinuria and hematuria in 2 siblings 19 hours ago

I think this is genetic FSGS in both siblings. The absence of hypoalbuminemia makes Primary FSGS very unlikely. About 10-15% of patients with genet...

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RE: Proteinuria and hematuria in 2 siblings 19 hours ago

I agree this is secondary FSGS based on pathology and on no edema Would have predicted a COL4 a3-5 but that is not supported by the genetic studi...

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Proteinuria and hematuria in 2 siblings 20 hours ago

A 45-year-old male (Italian descent) was initially evaluated for proteinuria 10 years ago (at age 35) he also had microscopic hematuria. The protei...

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RE: MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 20 hours ago

From what I remember it's needed to make the diagnosis, but I've seen a very few patients with this condition. I don't know if screening for subcli...

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RE: MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 20 hours ago

Interesting idea. Without any overt polyneuropathy can a diagnosis of POEMS syndrome really be entertained? Just curious. -----------------------...

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RE: is it SIADH 21 hours ago

Dr. Rodby said uric acid levels useful as tiebraker, as I previosly said serum uric acid < 4 and or high FE- Urate favors SIADH. ---------------...

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RE: MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 21 hours ago

The presence of MPGN/TMA, an IgA monoclonal protein, pleural effusion and thrombocytosis make kidney involvement secondary to POEMS syndrome an imp...

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RE: MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 21 hours ago

Mesangial expansion, lobular accentuation -sounds like MPGN pattern of injury . What did the silver-methenamine stain show.- how many double contou...

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RE: is it SIADH 22 hours ago

And prof lerman --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Full House/Non Lupus nephropathy 22 hours ago

Are you dealing with Full house Lupus ( seronegative as in your cases) ,or , Full house non lupus nephropathy ( C1q, MPGN, membranous, IgA , po...

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RE: is it SIADH 22 hours ago

Thanks really helpful for some concepts that I struggle prof mellas / rodby / dr dastoor I will watch video Patient told me today he felt the l...

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RE: is it SIADH 23 hours ago

Not to confuse either , using a primary assessment of volume status in " Euvolemic " hyponatremia , is tricky . A distinction between " euvolemic...

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RE: is it SIADH 23 hours ago

not trying to confuse things Pt is euvolaemic however anti-diuretic hormone is inappropriately secreted. Euvolemia vs mild hypovolemia and be v...

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RE: MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 1 day ago

@Patricia D' Almeida Bianco: Was there any glomerular capillary wall duplication? Did this patient show thrombocytosis at anytime in the setting of...

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RE: Full House/Non Lupus nephropathy 1 day ago

Thank you Dr Rodby and Glassock Thank you for the articles, have read them. ------------------------------ Sandeep Magoon MD Nephrology Associ...

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RE: C3 or MGRS 1 day ago

The IgM paraprotein suggests a lymphocytic rather than a plasma cell clone. ------------------------------ Richard Glassock MD, FASN Emeritus Pro...

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RE: is it SIADH 1 day ago

@Muhammad Soobadar If you have 90 minutes free time , I suggest you review this lecture , which should answer all ( majority) your questions on hy...

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RE: C3 or MGRS 1 day ago

Dr. Glassock, can you elaborate on why you would consider anti CD20 therapy over antiCD38 for a diagnosis of PGNMID. --------------------------...

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RE: MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 1 day ago

The absence of EM in this case is a significant deficiency that might be remedied by out-sourcing the kidney biopsy material. This is also a classi...

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RE: Refractory membranous Nephropathy 1 day ago

OBI does not treat immunologically inactive disease with GBM remodeling. No surprise. This is not immunologically refractory MN. Just an opinion. ...

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RE: Refractory membranous Nephropathy 1 day ago

We did try obi x 2 doses in April. No response at all. --------------------------------- Dr. Hormaz Dastoor. MD, MSc, FASN Divisional Head of Nep...

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MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 1 day ago

MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein I would a...

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RE: is it SIADH 1 day ago

Alcohol excess can cause hyponatremia through several mechanisms, the most characteristic is beer potomania (solute-limited water excretion) and va...

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

Urine dipstick positive for blood and protein --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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

Crp mid 20 --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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

Creatine 1.10 Urine acr 0.5 g --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: is it SIADH 1 day ago

Why would urine (na +k ) 133 be in keeping with SIADH ? interested to learn According to prior research published by Edelman a simplified equati...

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RE: C3 or MGRS 1 day ago

I am coming to believe that Sanjeev Sethi is correct- Idiopathic (Primary ) IC -MPGN and C3GN are very uncommon "diseases"- best regarded as "patte...

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RE: is it SIADH 1 day ago

Does nephrostomy trigger ADH? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: is it SIADH 1 day ago

@ dr dastoor he is undernourished hit nail on head How does alcohol excess cause hyponatremia? Due to weight loss I have requested whole body CT...

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RE: is it SIADH 1 day ago

- Why would urine (na +k ) 133 be in keeping with SIADH ? interested to learn . Please correct me if am wrong If hypovloaemic hyponatremia then ...

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RE: C3 or MGRS 1 day ago

I think this is a case of PGNMID - IgM kappa. . . I would treat with RTX or OBI first. Later maybe with Bendamustine , with Hematology approval. Ju...

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RE: Refractory membranous Nephropathy 1 day ago

I do not think this is likely to be refractory MN, but is due to chronic remodeling offpermselectivit barrier. You could try OBI but I doubt it wil...

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RE: Suspected COL4 related disease 1 day ago

Alport syndrom withou hematuria is uncommon but can occur. With Obesity, would definitely consider SGLT2i and GLP1RA. ---------------------------...

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