RE: Mesangioproliferative immune complex GN with full house on IF but with negative serologies including ANA. 17 minutes ago

In a patient of this age and kidney pathology I always wonder about Concealed PGNMID. I would do a Pronase digested Paraffin IHC for monotypic LC a...

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RE: diagnosis? 21 minutes ago

If no growth retardation is present and genetic studies are negative, then a rare form of Adult acquired Bartter -like syndrome needs to be conside...

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RE: diagnosis? 1 hour ago

Almost certainly congenital with such prominent nephrocalcinosis. Metabolic alkalosis with hypokalemia and hypercalciuria suspicious for Bartter....

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Mesangioproliferative immune complex GN with full house on IF but with negative serologies including ANA. 3 hours ago

Appreciate input from ASN Community regarding management of this patient. 71-year-old female patient with past medical history significant for hy...

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RE: anti gbm/mpo +ve in young female 4 hours ago

Thanks. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

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RE: Full house with negative serolgy 4 hours ago

I need to clarify my response- RF levels are usually normal in APSGN and in infection related IgA dominant GN. So the " RF rule" is not valid in al...

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RE: anti gbm/mpo +ve in young female 4 hours ago

Just send the paper in gmail accountBajinder Sent from my iPhoneSpelling mistakes are regretted which are not intentional

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RE: anti gbm/mpo +ve in young female 5 hours ago

Thanks. Who is the first author so I can find the paper on PubMed?. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949...

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RE: Full house with negative serolgy 5 hours ago

Thanks really helpful --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: anti gbm/mpo +ve in young female 5 hours ago

See this paper Glomerular disease journal 2025) 5(1) 68-73 Mitigated clinical course of crescentic GN with antigbm positive ----------------------...

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RE: diagnosis? 5 hours ago

Both secondary hyperaparathyroidism and elevated levels of 1,25 dihydroxy Vitamin D can be found in Bartter syndrome and are linked to hypercalciur...

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RE: Full house with negative serolgy 5 hours ago

I agree fully with Dr. Rodby's concerns. If the RF is normal an underlying IRGN is very unlikely,n especially if C3/4 levels are also normal.. just...

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RE: Full house with negative serolgy 6 hours ago

I think you have to be VERY careful to not miss an IRGN, especially the culture negative endocarditis related infections. We have diagnosed more th...

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RE: Full house with negative serolgy 6 hours ago

@ dr Sara / colleagues thanks for case Concerning your question about infection if patient has sign of infection ( symptoms , or fever or clinical ...

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RE: diagnosis? 6 hours ago

And where will we fit high pth and high 1,25 hydroxy VIT d3 with diagnosis of barrter? Yahoo Mail: Search, organise, conquer On Thu, 19 Feb 20...

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RE: diagnosis? 8 hours ago

I will check urine chloride , Can we use nsaids for prolong period with this creatinine and marked nephrocalcinosis? Yahoo Mail: Search, organise,...

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RE: diagnosis? 8 hours ago

Another diagnosis would be Dent Disease, as this genetic disorder can also present with Bartter -syndrome like features. Generic treating shoukd he...

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RE: diagnosis? 9 hours ago

I would give serious consideration to a diagnosis of Bartter Syndrome, Type 1 or 2. Can you obtain genetic studies?. What is the urinary chloride e...

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diagnosis? 11 hours ago

33 years old male with no prior co morbidities was admitted twice in outside facility with hypokalemic periodic paralysis twice requiring intubatio...

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RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 14 hours ago

Hi Dr Mohiuddin thanks for reply What was her proteinuria level before bone marrow transplant and albumin ? Then one year after and 18 month after...

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RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 18 hours ago

Auto BMT was in March 2023. Sent from my iPhone

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RE: Salmonella Sepsis and C3 GN???? 21 hours ago

Should gear to biopsy ( not hear) Thanks --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Salmonella Sepsis and C3 GN???? 21 hours ago

Thanks prof glassock What about c4d/c1q - evidence of classical pathway activation ? Also in PSGN if no active infection how do you treat ? Is A...

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RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 21 hours ago

Thanks prof glassock This patient has AL in 2022 Not clear what date bone marrow transplant was done and would be helpful to know. Serum free ligh...

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RE: Salmonella Sepsis and C3 GN???? 21 hours ago

IRGN is a generic term embracing all forms of infection related GN (bacteria, virus, fungi, Protozoa, helminths). Acute Post streptococcal GN (APSG...

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RE: anti gbm/mpo +ve in young female 21 hours ago

This is a great forum to hear about interesting cases and learn from each other. Special thanks to Dr. Glassock and Dr. Rodby for sharing their exp...

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RE: Salmonella Sepsis and C3 GN???? 21 hours ago

I guess the million dollar question will you send for complement factor and genetic studies if c4 remains low after 3 month ? ------------------...

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RE: Salmonella Sepsis and C3 GN???? 21 hours ago

Have you checked cryo? Rf and hepatitis ? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Salmonella Sepsis and C3 GN???? 21 hours ago

@ dr hormaz iRGN ( I suspect you mean infection related GN) PSGN -(post streptococcal GN) Can you explain why you think IRGN involves classical...

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RE: anti gbm/mpo +ve in young female 22 hours ago

Thanks appreciate the sharing and learning from paediatric nephrology Kind regards --------------------------------- Muhammad Soobadar MBChB U...

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RE: Fibrillary GN, unresponsive to rituximab 22 hours ago

Thanks Yes they don’t work on plasma cells or memory cells which in conditions like AL amyloid or IG a vasculitis with clone use of bortezomib or...

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RE: Fibrillary GN, unresponsive to rituximab 22 hours ago

Both RTX and OBI are monoclonal antibodies against CD20 -they bind to and eliminate CD20+ /CD19+ B-cells but they do not eliminate CD20-/CD19+ B ce...

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RE: Hypercalcemia in ESRD 23 hours ago

Thanks for case What was PTH, alkaline phosphate before hospitalisation ? Has he ever had bone biopsy ? If he has adynamic disease then giving b...

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RE: anti gbm/mpo +ve in young female 23 hours ago

I do not think that I have done anything.I have had only 2 boys that I can recall who had SLE with renal involvement with DPGN. They were pre teens...

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RE: Fibrillary GN, unresponsive to rituximab 23 hours ago

OBI and RTX are effective in CD20+/CD19 +B cell but would be ineffective in CD19+/CD20-B Cell mediated Disease @ prof glassock please explain ? ...

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RE: Fibrillary GN, unresponsive to rituximab 23 hours ago

Thanks I guess need to look retrospectively at serum of fgn without obvious cause Look at serum levels of the heat shock protein and see post ri...

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RE: Normocalcemic Hyperparathyroidism or Idiopathic Hypercalciuria 23 hours ago

Worsening BMD on serial measurements will be an important determinant of the need to consider PTX in this 39 year old patient> Dr. Sprague: Is tr...

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RE: AKI - D 23 hours ago

Dr. Shakeel: Please ask the rehab center to obtain daily body weights and urine volumes. You can also have that center to draw blood biochemical pr...

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RE: Fibrillary GN, unresponsive to rituximab 1 day ago

I am not sure that Fibrillary GN is a clonal disorder (monotypism is rare). We do not know if CD19+ B Cells are crucial for FGN either. no trials w...

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AKI - D 1 day ago

I saw the patient in the hospital who had sepsis syndrome after abdominal surgery and subsequently AKI requiring dialysis She recovered her sepsis...

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RE: Fibrillary GN, unresponsive to rituximab 1 day ago

Thanks . What element of pathophysiology of this disease points to c19 as culprit? Like in this case Curious to learn Many thanks ------------...

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RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 1 day ago

Relapse of AL amyloid despite stem cell transplant --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 1 day ago

Yes relapse in context of stem cell transplant . Question is it only relapse or rejection of stem cell transplant (I don’t have knowledge on this ...

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RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 1 day ago

Dr. Soobadar - What aspect of his evaluation would you point to as indicating relapse of this underlying disease-AL Amyloidosis?. --------------...

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RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 1 day ago

Thanks dr Mohiuddin There is important consideration here.This this relapse of disease in stem cell transplant patient Does it also mean rejecti...

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RE: anti gbm/mpo +ve in young female 1 day ago

Thanks dr Asha really helpful And for boys ? @ prof glassock - thanks for your clear statement . In summary its case based approach . If someone...

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RE: Normocalcemic Hyperparathyroidism or Idiopathic Hypercalciuria 1 day ago

Thanks Dr Glassock and Dr Sprague. Phosphate has been normal throughout. ------------------------------ Awais Nauman HMC Doha ----------------...

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Indolent crescentic GN 1 day ago

Hi everyone. I need your support with this case. 49-year-old female. Since 2021, she has had progressive proteinuria, reaching up to 3.5 g/24 ...

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RE: anti gbm/mpo +ve in young female 1 day ago

It is more of a concern in post-pubertal girls. We routinely refer our SLE children to fertility preservation clinics and they do multiple things (...

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RE: anti gbm/mpo +ve in young female 1 day ago

Dr. Soobadar - you are asking guidance for declaration of futility in cases of severe anti-GBM disease with oligio-anuria, dialysis dependent kidne...

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