RE: Membranous Nephropathy 10 minutes ago

Is the PLA2R IgG the IFA assay for anti-PLA2R antibody. If so, this test is more sensitive than the ELUSA . I n this case I would pay attention to ...

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RE: Digital Ischemia with CKD in a 70-Year-Old: Atherosclerosis vs Triple-Positive APS vs Cryoglobulinemia? 16 minutes ago

Clinically, 4-disease processes present . 1) "malignant " atherosclerosis ,2) primary anti-phospholipid syndrome , 3) Cryoglobulinemia , Type I or ...

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Digital Ischemia with CKD in a 70-Year-Old: Atherosclerosis vs Triple-Positive APS vs Cryoglobulinemia? 3 hours ago

* 70-year-old male, heavy smoker * Known history of: * HTN * Type 2 DM (HbA1c ~7.6%) * Dyslipidemia * Hypothyroidism * Parkinson’s disease * ...

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RE: Postural hypotension 3 hours ago

Or unless the patient has concomitant volume depletion and autonomic dysfunction ------------------------------ Vito M Campese Professor Emeritus...

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RE: Membranous Nephropathy 6 hours ago

Thank You for your reply. The test is from Quest diagnostics. PLA2R Ab, ELISA is a quantitative test while PLA2R IgG is a qualitative test (Posit...

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RE: complex case of nephrotic syndrome in liver transplant patients 6 hours ago

Could you add a graph of UACR or UPCR to correspond with her course since stopping the Sirolimus ? You only show graphs of serum albumin and eGFR ....

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RE: Treatment uncertainty with Secondary TMA in Advanced HIV 6 hours ago

These findings seem most consistent with HIVICK - immune complex disease due to HIV infection.he needs aggressive tgerspybdirected to the HUV and H...

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RE: Membranous Nephropathy 6 hours ago

Very complex case. If I understand correctly the serum anti-PLA2R antibody levels have decreased to undetectable levels ([More]

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RE: Postural hypotension 8 hours ago

Thanks Dr. Venkat for the advice. I shall stop fludrocortisone. ------------------------------ Jaison George MD, MBBS Kollam, India ------------...

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RE: Postural hypotension 8 hours ago

Shy-Drager Syndrome, , now called Multisytem Atrophy (MSA) , is a very rare condition , not found as a complication of long-standing diabetes , usu...

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RE: Postural hypotension 9 hours ago

Thanks Dr. Leung, The supine BP was taken with midodrine. His hyponatremia was never symptomatic. ------------------------------ Jaison George M...

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RE: Postural hypotension 9 hours ago

Thanks Dr. Glassock. He is not on beta blocker. ------------------------------ Jaison George MD, MBBS Kollam, India ------------------------------

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RE: Postural hypotension 10 hours ago

Does patient have any neurological symptoms or signs Could it be Shy Drager Syndrome Severe autonomic neuropathy if not from Diabetes mellitus ...

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RE: VIH persistence of serology showing low-level HIV antibodies (2.64) by ELISA and a negative viral load in an old patient 12 hours ago

Most 4th generation Anti-HIV antibody tests are claimed to have 99.5% specificity ( 0.5% false positive rate. ) if a 4th generation assay was utili...

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RE: complex case of nephrotic syndrome in liver transplant patients 12 hours ago

Thanks prof glassock . Sorry late reply March 24 sirolimus started August 24 normal urine pcr August 25 urine pcr 4g with low albumin and sirolimu...

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Membranous Nephropathy 12 hours ago

44 year old Hispanic male with gout, HTN diagnosed with membranous nephropathy 8/2023 – KIDNEY, BIOPSY: - MEMBRANOUS NEPHROPATHY, PLA2R ASSOCIA...

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RE: VIH persistence of serology showing low-level HIV antibodies (2.64) by ELISA and a negative viral load in an old patient 21 hours ago

I would do another antibody test for HIV to see that this is not a false positive. If that is negative, and the HIV RNA is also negative, that woul...

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VIH persistence of serology showing low-level HIV antibodies (2.64) by ELISA and a negative viral load in an old patient 1 day ago

Dear colleagues, could you please give me your opinion on this patient? This 94-year-old patient was started on dialysis in December 2022 following...

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RE: Postural hypotension 1 day ago

Long standing Diabetes mellitus seems poorly controlled Any information on any complications such as retinopathy peripheral neuropathy gastropares...

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RE: Dialyzer reaction 1 day ago

Interesting case. What were the serum sodium and urea levels prior to starting the hemodialysis session? If you are confident that the early in...

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Treatment uncertainty with Secondary TMA in Advanced HIV 1 day ago

A middle aged male with PMH HIV (not on HAART), seizure disorder, hypertension, and neurosyphilis treated years prior presented after two witnessed...

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RE: Postural hypotension 1 day ago

You might want to stop the medication with the Mitaconozolole as it might be aggravating the symptoms ot orthostatic hypotension. ---------------...

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RE: Postural hypotension 1 day ago

How do we know that the orthostatic hypotension is not a result of dehydration since he has nocturia 10 times a night? Was the supine blood pres...

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RE: Dialyzer reaction 1 day ago

Dear Dr, Chandran. Thank you for your input! Since our acute and chronic units do not typically stock AN69, it is not easy to obtain. I am planning...

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RE: Postural hypotension 1 day ago

The lack of postural tachycardia makes volune depletion unlikely. Unless the patient is on a BB ------------------------------ Richard Glassock M...

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RE: Postural hypotension 1 day ago

With a SPEP not showing a M spike and a UPCR of about 0.7gm/gm AL amyloid is likely. If the sFLC is normal I doubt that further evaluation for Amyl...

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RE: Postural hypotension 1 day ago

Thanks Dr. Glassock. Serum protein electrophoresis was negative. I shall do a free light assay as advised. Could these be amyloidosis? ----------...

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RE: Postural hypotension 1 day ago

Thanks Dr. Glassock. Didn't do a valsalva, shall do it. ------------------------------ Jaison George MD, MBBS Kollam, India ---------------------...

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RE: Dialyzer reaction 1 day ago

Dr Park: Your patient is exhibiting a strange reaction: Optiflex dialyzers are polysulfone & gamma ray sterilized. ST 150 is AN 69 sterilized with ...

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Dialyzer reaction 2 days ago

Good evening I am Jinwook Park, a nephrologist at Louisville KY. I'd really appreciate any thoughts or similar experiences on this case. Than...

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RE: Postural hypotension 2 days ago

Why is he so anemiic ? Have you done a bone survey And a serum Free light chain ? ------------------------------ Richard Glassock MD, FASN Lagun...

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RE: Gross Hematuria 2 days ago

Besides sickle cell trait (as already mentioned by Dr. Lerman), hypercalciuria (without overt nephrolithiasis) may cause recurrent gross hematuria ...

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RE: Gross Hematuria 2 days ago

The patient is Caucasian Jewish. CT Angiogram was negative for "Nutcracker". Urine cytology was negative. She has stopped running and will see what...

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RE: Postural hypotension 2 days ago

Looks like Diabetic autonomic neuropathy to me. Have you done Valsalva's maneuver? ------------------------------ Richard Glassock MD, FASN Lagun...

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Postural hypotension 2 days ago

Requesting opinion on this case: A 68 year old male presented with history of hypotensive episodes for the past 7–8 years, which are worse in the ...

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RE: Nephrotic range proteinuria, kidney biopsy showing lupus 2 days ago

Thanks for posting the report. While there is 1 glom with segmental hypercellularity, it seems mild at best, so while this could qualify as a cla...

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RE: Nephrotic range proteinuria, kidney biopsy showing lupus 2 days ago

Thanks Dr Glassock and Dr Venkat I have a attached a copy of kidney biopsy report as well as UA ANA neg c3,c4 neg anemia...

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RE: Nephrotic range proteinuria, kidney biopsy showing lupus 2 days ago

"negative serologies for anti-dsDNA, ANCA, and anti-PLA2R antibodies" Was ANA also negative? Coomb's test? ------------------------------ K.K. ...

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RE: Nephrotic range proteinuria, kidney biopsy showing lupus 3 days ago

Also- what is the nature of the anemia in this case? What is the result of the hematological indices snd blood smear.? --------------------------...

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RE: Nephrotic range proteinuria, kidney biopsy showing lupus 3 days ago

It would help if you can post a deidentified copy of thr kidney biopsy report (LM, IF, EM). Was the biopsy stained for DNA JB9 and IgG subclasses? ...

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Nephrotic range proteinuria, kidney biopsy showing lupus 3 days ago

Greetings to all the members, I would appreciate your input in this case. A 40-year-old woman was evaluated for incidentally detected nephrotic-ran...

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RE: Gross Hematuria 3 days ago

Thanks for all the good ideas. I have passed them on to the patient's internist and if he comes with a dx will let you know. Mike E -----------...

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RE: Pd Question 3 days ago

One more point; a patient intubated usually very sick and catabolic. Still need to maintain nutrition. Probably hemo better than PD in handling cat...

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RE: Pd Question 3 days ago

Thanks prof bargman very helpful and dr Jose Last question what antibiotics do colleagues use for cyst penetrance ? Kr ----------------------...

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Reminder: Encourage fellows to volunteer as case report reviewers for Kidney Week 2026! 3 days ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2026. The reviewing/gradin...

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Reminder: Volunteer by April 29 to serve as a case report reviewer for Kidney Week 2026! 3 days ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2026. The reviewing/gradin...

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RE: Pd Question 3 days ago

HAve seen a couple; Pulmonary folks did not want anything lifting diaphracm, plus fear of peritoneo-pleural leaks so catheter and hemo plus drain a...

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RE: complex case of nephrotic syndrome in liver transplant patients 3 days ago

How long did you observe the patient without therapy after stopping Sirolimus? This is crucial information lacking in your presentation ---------...

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RE: Pd Question 3 days ago

There are a lot of theories as to why intensivists are so opposed to PD, especially because there is no evidence for this. Probably much of this is...

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RE: complex case of nephrotic syndrome in liver transplant patients 3 days ago

Rituxan seemed to have done the trick . --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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