RE: Resistant Childhood Nephrotic Syndrome and Negative Genetic Testing 7 minutes ago

Dear All, I absolutely agree and appreciate for dissecting and analyzing the patient so well. His interpretation and diagnostics acumen can only be...

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RE: Anca vasculitis relapse without circulating antibodies 34 minutes ago

Thank you, Dr. Glassock, for sharing the research paper. I believe we can consider the possibility of thrombotic microangiopathy (TMA), especially...

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RE: IgA nephropathy with recurrent RPGN 50 minutes ago

Will it be possible for you to post the first biopsy report ? Was it a true crescentic IgA or IgA with crescents ? ------------------------------...

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RE: IgA nephropathy with recurrent RPGN 1 hour ago

Did your patient have gross hematuria or was it only microscopic? Gross hematuria occurring in patients not on anticoagulation has been reported to...

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RE: Resistant Childhood Nephrotic Syndrome and Negative Genetic Testing 2 hours ago

Your patient almost certainly has X-linked Alport Syndrome, in my opinion . Up to 20% of such patients will have false negative tests for pathogeni...

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Resistant Childhood Nephrotic Syndrome and Negative Genetic Testing 4 hours ago

Dear Colleagues 14 year old male, Hypothyroidism, proteinuria discovered on routine investigations two years ago, Initial Albumin 32, 24 Hr Urine...

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RE: IgA nephropathy with recurrent RPGN 5 hours ago

From your description the prior episode of biopsy proven crescentic IgAN when treated with IV CYC + Steroids had a full remission and restoration o...

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RE: Anca vasculitis relapse without circulating antibodies 6 hours ago

Great question, very difficult to specifically answer - your proposal is possible, but impossible to prove. M0 lesions are fairly common (27%) in p...

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RE: Anca vasculitis relapse without circulating antibodies 6 hours ago

Am I correct to think that the presence of mesangial IgA deposition in this case is likely incidental rather than indicative of IgA nephropathy, es...

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IgA nephropathy with recurrent RPGN 8 hours ago

Good day, I have a 47 yrs old known crescentic IgA N Diagnosed 3 yrs back, previously inducation with cyclophosphamide 500 mg, 6 dosed and pulse...

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RE: Anca vasculitis relapse without circulating antibodies 13 hours ago

Serum creatinine, hematuria and proteinuria all increased very significantly. I think this is a relapse of crescentic IgAN with RPGN, partially tre...

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RE: Anca vasculitis relapse without circulating antibodies 13 hours ago

Again, I am not convinced he relapsed based on increase in creatinine alone, ANCA now negative CD 19 supressed Personally I would not escalat...

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RE: IgA nephropathy 14 hours ago

Kidney Biopsy Sample size is borderline. This makes it a bit more difficult to be sure about C0 score. Were many RBC casts observed in renal tubula...

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RE: Anca vasculitis relapse without circulating antibodies 17 hours ago

Thank you very much for the discussion. It was very helpful! ------------------------------ Tiago Cerqueira, MD, MSc, MBA, FASN Evangelical Hospi...

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RE: DR MISMATCH in Kidney Allocation 20 hours ago

So sorry try this 10.7759/cureus.30189 ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director K...

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RE: DR MISMATCH in Kidney Allocation 21 hours ago

Thank you Dr lerman, but unfortunately this link doesn't work https://doi.org/10.7759/cureus --------------------------------- Ahmed Emara MD, M...

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RE: IgA nephropathy 22 hours ago

If you have access to Budenoside I would prefer to start and get her into remission. Time averaged proteinuria is associated with worse kidney surv...

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RE: DR MISMATCH in Kidney Allocation 22 hours ago

No significant difference in graft survival between LRD vs LURD kidney transplants though incidence of AR may be higher in unmatched live donors (L...

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RE: IgA nephropathy 23 hours ago

Thanks a lot dr Glassock sample size 11 Glomeruli no crescents , EM already done revealed renal cortex with glomeruli. Ultrastructu...

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RE: Anca vasculitis relapse without circulating antibodies 23 hours ago

Great question. I think I would prefer MMF over RTX, since he seems to have crescentic IgAN, not IgAV and relapsed with full B cell suppression. ...

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RE: IgA nephropathy 1 day ago

This is a tough one. Can I assume that no crescents were seen (C0)? What was the sample size (# glomeruli). I guess no EM was done- so a coincident...

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RE: Anca vasculitis relapse without circulating antibodies 1 day ago

It makes a lot of sense, since his KB shows a lot of chronic interstitial lesions that may be compatible with an underlying disease that had been g...

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RE: IgA nephropathy 1 day ago

tjanks a lot Pro Glassok for your reply Blood pressure now controlled 120/67 on telmisartan 20 mg then increased to 40 mg BMI 19 ( BW 59 kg...

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RE: DR MISMATCH in Kidney Allocation 1 day ago

Thank you Dr Satin so much Based on this paper, the number of mismatches rather than the specific loci of matches is the issue that matters. Do I...

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RE: IgA nephropathy 1 day ago

Additional information needed. What is the BP now?What was the degree of hematuria at presentation and now.? What was the Oxford-MEST-C score for t...

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IgA nephropathy 1 day ago

27 years old female patient presented with headache and Hematuria Blood pressure 230/110 creatinine 150 blood pressure controlled 24 ho...

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RE: Would you rebiopsy? Is this C3GN? 1 day ago

Great question. I kind of doubt that this lesion falls within the spectrum of "Lupus Podocytopathy" but will defer judgement to my Nephropathology ...

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RE: DR MISMATCH in Kidney Allocation 1 day ago

See this paper ------------------------------ Satish Balan MD DM DNB Senior Consultant Department of Nephrology Kerala Institute of Medical Scie...

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RE: Would you rebiopsy? Is this C3GN? 1 day ago

Given positive ANA and anti-ds-DNA antibody and only very sparse electron deposits, could this be lupus podocytopathy? --------------------------...

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RE: neuropsychiatric Management 1 day ago

Thank you! ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ------------------------------

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RE: neuropsychiatric Management 1 day ago

see Mendez LMG, et al CJASN 2018; 13: 1502-1509. Post Hoc analysis of the LUNAR trial. ------------------------------ Richard Glassock MD, FASN L...

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RE: neuropsychiatric Management 1 day ago

@Richard Glassock Could you please tell us where this post-hoc analysis of the Lunar study which showed a beneficial effect of rituximab was publ...

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RE: lupus nephropathy ? 1 day ago

Looks like non lupus full house I will suggest to skin biopsy for immunoflorence studies If full house pattern on skin biopsy, will watch for deve...

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RE: lupus nephropathy ? 1 day ago

This case should most probably be classified as "Non-Lupus Full House Nephropathy " (NLFN) not Lupus Nephritis. I doubt C3GN, but this is always po...

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RE: neuropsychiatric Management 1 day ago

Dr. Balan-you are quite correct that the LUNAR trial of RTX in LN failed to meet its Primary Efficacy end-poiint. But subsequent post-hic analyses ...

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lupus nephropathy ? 1 day ago

Hello to the entire community, Please allow me to request your opinions regarding a young patient, 14 years old, from a non-consanguineous marria...

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RE: Would you rebiopsy? Is this C3GN? 1 day ago

Thanks for posting the report . ED subepithelial C containing deposits by EM is not compatible with " Minimal Change Disease". We need expert consu...

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RE: Crescentic GN, IgA, Pulm Hemorrhage and low C' 1 day ago

At least for IgAN with crescents we have good information on intensity of C3 deposition. See Obrisca B, et al BMC Nephrol 2024;25:145. This kind of...

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RE: Crescentic GN, IgA, Pulm Hemorrhage and low C' 1 day ago

My take is a bit different. The clinical presentation is quoted compatible with IgA Vasculitis. Admittedly the low C3 and C4 are disconcerting, but...

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RE: Would you rebiopsy? Is this C3GN? 1 day ago

Biopsy results attached ------------------------------ Nimra Sarfaraz (516) 637-3820 ------------------------------ Files Attached DocumentRE:...

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RE: Crescentic GN, IgA, Pulm Hemorrhage and low C' 1 day ago

I agree the IgA may be a red herring, THIs severe a case with so many autoimmune markers suggests a drug induced vasculitis. Is was the patient ...

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Crescentic GN, IgA, Pulm Hemorrhage and low C' 1 day ago

Colleagues, Looking for a unifying dx and direction on further therapy. 80 yo woman with no past medical history presented in renal failure (Cr...

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RE: ATI, Anuria post kidney transplant 1 day ago

Evidence for Obinutuzumab based on phase 2 study presented at 2024 ASN although encouraging far from definitive - would proceed with Rtx and slowly...

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RE: DR MISMATCH in Kidney Allocation 1 day ago

Another point, please Can I know the number of kidney transplant for 6 mismatched couples or DR mismatched couples done recently in the US ? is th...

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RE: neuropsychiatric Management 1 day ago

In all the neuropsychiatric relapses of lupus that I have treated, and almost all of them are due to non-compliance, I have used cyclophosphamide m...

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RE: Anca vasculitis relapse without circulating antibodies 2 days ago

Thanks- the KB is consistent with Crescentic IgAN or IgAV. Did the patient have arthralguas, abdominal pain or a leukocytoclastic skin rash at init...

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RE: neuropsychiatric Management 2 days ago

Opinion but not evidence based suggestion would be that parenteral agents are preferred in a non-compliant patient with LN and CNS involvement- I w...

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RE: Anca vasculitis relapse without circulating antibodies 2 days ago

Hi Prof Glassock, Unfortunately, EM wasn't carried out. The LM and IF were: Light Microscopy: Processed material, four slides prepared conta...

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RE: Pla2r positive MN 2 days ago

The addition of two vasodilating drugs may help to explain the rising proteinuria. Neither seen to be indicated. Do you have a recent antiPlA2R ant...

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RE: Pla2r positive MN 2 days ago

So this gentlemam, actually 74 year old Arrived on March 2024, pla2r 346, eGFR>60 urinary PCR 6340 Urinary ACR. 5015 On April PCR 15500,...

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