RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 4 hours ago

It was not a question,just an observation from a large (n=64) study of patients with IgA deposition in a renal allograft. (Ganesh et al 2024) 18/64...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 5 hours ago

Dr. Glassock, I do not understand your question. Please clarify it. The paper you cited (attached) just reinforces the ongoing discussion: " the po...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 7 hours ago

For the Transplant Nephrologists here is an interesting study of "incidental" IgA deposition in long term allografts with chronic allograft Nephrop...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 8 hours ago

No personal experience with anti-CD38 therapy in AMR. I have found that late-onset AMR (> 6-12 months post-transplant), especially with transplant...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 9 hours ago

Thank you for sharing this case Want to know if this patient had previous rejection ? Whats his averrage tacrolimus trough level ? Any recent ...

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RE: Proteinuria and hematuria in 2 siblings 10 hours ago

@Michelle Rheault thank you for your comments. We discussed these 2 cases at our case conference today and 2 geneticists from Natera were there. ...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 10 hours ago

agree there is mesangial proliferation with mesangial IgA deposits-significant chronic changes. so combination IGAN (whether recurrent vs de novo ?...

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RE: Light chain proximal tubulopathy 12 hours ago

Can we see the deidentified kidney biopsy report. Physiologic protein reabsorption droplets should not be monoclonal. What is the UACR, UPCR and a ...

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RE: is it SIADH 12 hours ago

See also Feldman BJ et al NEJM 2005 ;352:1884-1890 for a description of the infantile X-linked form of NSIAD. Could certain drugs, like Sertraline,...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 13 hours ago

What about the IF staining looks like strong postive for IgA In this longstanding kidney transplant would you consider this denovo IgA or second...

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RE: is it SIADH 13 hours ago

as promised see post very interesting IMO ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush Unive...

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RE: is it SIADH 13 hours ago

NSAID means non steroidal anti inflammatory drugs, like NSAIA non steroidal anti inflammatory agents I think the more preferred term is now SI...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 13 hours ago

@Jonathan Zuckerman As a non-pathologist, I see mesangial expansion and cellular proliferation plus primarily mesangial deposition of IgA. The PA...

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RE: Light chain proximal tubulopathy 13 hours ago

wow love this case don't see enough tubular (potential) MGRS nothing on EM? ------------------------------ Roger Rodby MD, FASN Professor ...

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Light chain proximal tubulopathy 14 hours ago

62 yo WF with MGUS, stage 3a CKD and proteinuria. Repeat kidney biopsy shows acute tubular injury. Proximal tubules with cytoplasmic protein reabso...

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RE: therapeutic Lovenox dose in an ESRD setting 14 hours ago

Due to delayed clearance and variable pharmacokinetics, LMWH is not desired in ESKD as it requires careful monitoring and reduced dosing , unfracti...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 14 hours ago

Opinions from Transplant nephrologists /pathologists needed (Drs Rubin, Lerman, Venkat, Zuckerman ) but this looks like chronic transplant Glomerul...

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RE: is it SIADH 14 hours ago

I guess this might better be called a Nephrogenic Syndrome of anti-diuresis (NSAID) , not SIADH. In this case circulating ADH and Copeptin would be...

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RE: is it SIADH 14 hours ago

Sertraline has been associated with drug induced hyponatremia/SIADH. so that is a possibility. Surprisingly in isolated inner medullary collectin...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 14 hours ago

Biopsy report from @David Bourne (Arkana). DSA negative. See table below for Banff classification of the biopsy findings: ACUTE Interstit...

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therapeutic Lovenox dose in an ESRD setting 15 hours 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 16 hours 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 16 hours 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 17 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 18 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 18 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 19 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 22 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day ago

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

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RE: Full House/Non Lupus nephropathy 1 day 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 1 day 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 1 day 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 1 day 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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