RE: ICI induced IgAV 3 hours ago

I thought of it LDH 388 slightly elevated Ferritin 1450 significantly elevated Triglyceride 1.7 normal Platelets 129 LFTs normal We do...

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RE: MPO VASCULITIS 6 hours ago

Thank you Dr Aledan. The patient you referred had autoimmune hepatitis and might have been the reason for positve MPO titers ------------------...

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RE: ig a case is it alcohol/liver disease related. 8 hours ago

My answer to your 2 Questions is No. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine at UCL...

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RE: nephrotic syndrome with 8 hours ago

Not necessarily. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine at UCLA Laguna Woods CA (9...

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Crescentic ig a in transplant case 9 hours ago

18M, Issues: 1) Declining kidney function - Suspected rejection: Admits to poor compliance with tacrolimus Previous negative DSAs July 202...

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RE: ig a case is it alcohol/liver disease related. 9 hours ago

C3 and C4 levels, HBV status -ve cant find ANCA is diagnosis of abdominal pain in Ig a on kidney biopsy enought to label Ig a v . no documentatio...

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RE: nephrotic syndrome with 9 hours ago

What is seum albumin? 17.6 , C3 and C4, HCV and HBV status.? all negative RF /BM/Cryo Not done @prog glassock would you not need to gi...

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RE: ICI induced IgAV 12 hours ago

"I'm wondering if the levofloxacin caused a flare up! There are reports that fluoroquinolones may accentuate the immune response to Immune checkpoi...

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RE: ICI induced IgAV 14 hours ago

Can you provide/do HLH-related studies, eg ferritin? --------------------------------- Oded Friedman ---------------------------------

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RE: Anti-gap positive metabolic acidosis 14 hours ago

Thank you, Dr. Grimm. I was well aware of several things that artifactually reduced the serum HCO3 and thereby raised the AG, such as hyperlipidemi...

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RE: Anti-gap positive metabolic acidosis 14 hours ago

The pseudo hypo bicarbonate would a potential explanation however mother said the used small tubes and they were fairly full. Sent from my iPhone O...

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RE: Anti-gap positive metabolic acidosis 15 hours ago

The PCO2 was 37 and the calculated bicarb was 21.7 on the venous blood gas, which had a pH of 7.35. The blood gas was done four days after the orig...

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RE: Anti-gap positive metabolic acidosis 16 hours ago

Thanks - would this explain venous PH 7.35 @James Hasbargen MD what was PCO2 and calculated HCO3 on VBG and when in reference to original lab was i...

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RE: ICI induced IgAV 16 hours ago

Thanks Dr Rodby! you're right! Its uncommon in IgA vasculitis, but I came across reports on IgA vascultitis induced by immune checkpoint inhibitors...

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RE: Anti-gap positive metabolic acidosis 16 hours ago

Good morning. My diagnosis is that this is a classic case of pseudo-hypo-bicarbonatemia. We are literally getting consults like this every week o...

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RE: ICI induced IgAV 16 hours ago

Fever in not that common in IgAV. I would reinitiate the ceftriaxone and increase steroids a bit (cover both bases) until PET is done. just an o...

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RE: ICI induced IgAV 20 hours ago

Thanks Dr Glassock, update on this patient, his fever spikes to 39 and 40 degrees so I admitted him for extensive infectious work up (before rituxi...

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RE: Nephrotic syndrome with massive bilateral PE 20 hours ago

DOCA is better in morbidly Obese but warfarin better in severe NS. So LMWH maybe better until proteinuria and albumin inproved it can be dosed and,...

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RE: Nephrotic syndrome with massive bilateral PE 21 hours ago

Dr. Glassock. Thanks for the vital question. As I mentioned, to my knowlage no study test this hypothesis and all studies were on primary prophylax...

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RE: Nephrotic syndrome with massive bilateral PE 21 hours ago

Dr. Aledan- thanks- do you mean that Apixaban is a better choice than Warfarin in secondary prevention of VTE in severe NS- if so , why? --------...

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RE: MPO VASCULITIS 23 hours ago

A rare case reports showed a possible association . The classic reference is a Japanese autopsy case of MPO-ANCA vasculitis with autoimmune hepat...

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RE: Nephrotic syndrome with massive bilateral PE 1 day ago

The comparative data of VTE in nephrotic syndrome is small and retrospective and most on primary prophylaxis rather than secondary prevention of li...

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RE: Nephrotic syndrome with massive bilateral PE 1 day ago

Do DOAC work as well (efficacy) as Warfarin ,in preventing a recurrence of a life-threatening VTE in a morbidly obese patient with presumably treat...

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RE: Nephrotic syndrome with massive bilateral PE 1 day ago

not to be picky but "Warfarin here, wouldn't trust NOAC) " DOAC may be safer in ACUTE PE unless CKD( CREAT CL < 30ML/MIN ), LIVER DZ, APLS, prostat...

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RE: MPO VASCULITIS 1 day ago

Gastroentrelogist . Thanks Dr Glassock I looked at the literature and I could not find any association. ------------------------------ Dwa...

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RE: MPO VASCULITIS 1 day ago

Where did the suggestion of "paraneoplastic association of elevated anti-MPO antibodies" come from. The anti-MPO antibody is most likely an associa...

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RE: Anti-gap positive metabolic acidosis 1 day ago

was this the venous BG taken when AG WAS 18 or later ? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medi...

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RE: MPO VASCULITIS 1 day ago

Thanks Drs Glassock and Dr Rodby. Alpha fetoprotein is not elevated. Started on empirical therapy despite a suggestion whether raised MPO tite...

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RE: Sclerosing peritonitis 1 day ago

Thank you, Dr Rodby and Dr Bargman. This was the same pt I had presented a few months back. He has FSGS and lost his first transplant within a mo...

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RE: Sclerosing peritonitis 1 day ago

I agree with you. Any kind of surgical intervention would be fraught and unlikely to turn out well. Hopefully it will settle down over time. The ba...

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RE: Anti-gap positive metabolic acidosis 1 day ago

Obtained venous pH which was 7.35. Accompanying electrolytes had a serum HCO3 of 20 for an anion gap of 13. A repeat urinanalysis was also done wit...

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RE: Tuberous sclerosis in 34 year old 1 day ago

According to my AI colleague,Claude - there are no firm data showing that mTOR inhibition is of value to reduced Kidney Cyst burden (as compared to...

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RE: Nephrotic syndrome with massive bilateral PE 1 day ago

This issue of maximizing the speed of Remissions of NS by manipulating the use of drug combination for initial therapy is one common to MCD and MN....

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RE: Nephrotic syndrome with massive bilateral PE 1 day ago

I doubt the CNI expedites anything except lowering of proteinuria until Rituximab kicks in. may decrease morbidity. ----------------------------...

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RE: Tuberous sclerosis in 34 year old 1 day ago

She has significant CKD for TS and just some cysts which I suspect are more than being mentioned given the eGFR. Mtor inhibitors are great for a...

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RE: Nephrotic syndrome with massive bilateral PE 1 day ago

Nice response Dr. Rodby- thanks for all of the References. I guess that CNI + RTX combois reasonable but I know of no study showing that the additi...

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RE: Sclerosing peritonitis 1 day ago

EPS at age 17, that is just terrible. How long had the patient been on PD? You said it was spontaneous, bet there was an abscess. My limited ...

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Sclerosing peritonitis 1 day ago

Dear all, This is a follow-up question for a 17-year-old patient whom I have inherited, who has sclerosing encapsulating peritonitis. I was getti...

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Tuberous sclerosis in 34 year old 1 day ago

Hello everyone, 34-year-old healthy female came to clinic for evaluation of elevated creatinine of 2.0. Creatinine of 1.06 in 2022,no labs prese...

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RE: nephrotic syndrome with 1 day ago

Has a bone marrow been done to evaluate IgM kappa and IgM lambda monoclonal bands Rheumatoid factor Cryoglobulins? -------------------------...

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RE: MPO VASCULITIS 1 day ago

I suspect this patient could be treated without a kidney biopsy. But I would wonder If HCC is diagnosed that what would be the treatment? If this p...

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RE: Nephrotic syndrome with massive bilateral PE 1 day ago

I have attached several articles on ritxumab as a first line therapy for steroid responsive NS THe response is variable but I think Dr Glassock'...

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RE: Nephrotic syndrome with massive bilateral PE 2 days ago

Agree with Dr. Glassock that steroids are not my first choice due to morbid obesity and possible steroids AEs she may have. Proteinuria reduction ...

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RE: MPO VASCULITIS 2 days ago

No hydralazine therapy is reassuring. With platelets of 100,000 ,off Apixaban and normal INR a kidney biopsy would likely be reasonably safe. unusu...

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RE: Nephrotic syndrome with massive bilateral PE 2 days ago

The average time to CR for RatX monotherapy of MCD is about 25 days, and can be as short as 12 days. I am not sure that Prednisone is any quicker a...

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RE: Nephrotic syndrome with massive bilateral PE 2 days ago

There is really no evidence on triple therapy. I'm just adding Tac to limit steroids exposure, and this is as a bridge to rituximab until it takes ...

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RE: Nephrotic syndrome with massive bilateral PE 2 days ago

Thanks Dr Glassock. So you would just give Rituximab alone? Are steroids contraindicated during acute PE? I mean do they have prothrombotic ef...

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RE: MPO VASCULITIS 2 days ago

Thanks Dr Glassock. Platelets: 101000 101 L x 10^9/L Hb 8g/dl; INR 1.3 , Urine: No red cell casts or acanthocytes, HBV, HCV: Non-reacti...

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RE: ig a case is it alcohol/liver disease related. 2 days ago

This might be IgA Vasculitis complicating chonic alcoholic liver disease explaining the biopsy findings and the abdominal pain. (Visceralvasculitis...

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RE: nephrotic syndrome with 2 days ago

What is seum albumin, C3 and C4, HCV and HBV status.? Is he receiving anticoagulants. Prostatic cancer will not be a contraindication to chemothera...

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