RE: Diffuse Lymphoid infiltrate on native kidney biopsy w/o lymphoproliferative disorder. 6 hours ago

Does diet, including food coloring, and medication history indicate unusual intake. The recovery is against the diagnosis of lymphoma. Did the pati...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 6 hours ago

With all due respect for your valuable opinion -my opinion differs. If the anti-PLA2R antibidy was undetectable ([More]

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 8 hours ago

Speaking for myself, I do not see a need to rebiopsy. As I see it, persistent proteinuria could be due to three reasons. Incomplete remission, rela...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 9 hours ago

I would not, in general, but the specific detaiils of individual cases (e.g. RPGN or AKI) might warrant a rebiopsy. It depends! -----------------...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 10 hours ago

Dr Glassock, please clarify:if " the immunologic sink phenomenon is usually quite transient, so that it can often be recognized by serial measureme...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 10 hours ago

This is an interesting but very timely question. Membranous nephropathy, like other 'primary' nephrotic syndromes follows a different trajectory in...

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RE: Light chain deposition disease in transplant kidney allograft 10 hours ago

C4d deposition can be a feature of LCDD in the kidneys, I do not think that this minimal finding necessarily indicates the concomitant presence of ...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 13 hours ago

Dr. Hirsch. These phenomena are quite uncommon, so data that might answer your questions is scanty . However, the immunologic sink phenomenon is us...

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RE: Light chain deposition disease in transplant kidney allograft 13 hours ago

Thank you for sharing this case . Seems that this is a case of denovo LCDD . However I would like to bring the attention of some findings in the bi...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 13 hours ago

Dr Glassock, For the patient I described, do you suggest a repeat biopsy to distinguish "immunologic sink" (and need for yet more immunosuppression...

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RE: Light chain deposition disease in transplant kidney allograft 16 hours ago

Thank you so much Dr. Glassock. ------------------------------ Pongstorn Pitiranggon MD Pee Dee Nephrology Florence SC (843) 669-6694 -----------...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 18 hours ago

These kind of patients are very uncommon, but have been described. A repeat kidney biopsy often shows extensive ( *? Irreversible) capillary wall c...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 19 hours ago

There is phenomenon that I never understood well when a patients with PLA2R Membranous and in CR with negative PLA2R present with worsening protein...

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RE: Light chain deposition disease in transplant kidney allograft 23 hours ago

We need to see the EM, Congo Red stain but this looks like de novo LCDD in a kidney allograft .An evaluation, involving complete blood cell count ,...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 1 day ago

Thanks Dr Hirsch. This is what make writing "Guidelines" and then applying them to individual patients so difficult. The more we know about "diseas...

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Light chain deposition disease in transplant kidney allograft 1 day ago

Seeking expert advice: This is a 55-year-old female with HTN, hyperlipidemia and ESRD due to IgA nephropathy and s/p DDKD in 2000 with good allog...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 1 day ago

In terms of "what is going on?", FWIW, I (n =1) have taken the PLA2R measurements seriously, based a lot on what I have learned from you guys in th...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 1 day ago

Thanks Dr. Rodby- the question as posted was very specific to PLA2R related MN in a complete clinical and immunological remission (anti-PLA2R antib...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 1 day ago

"Answer to Question posed by Dr Glassock is not really known" Don't you think that is why he asked It? I put my opinion out there, now you have t...

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RE: Patient with LCDD on kidney biopsy but no clone found in the bone marrow 1 day ago

Was Paraffin iF following Pronase digestion ever done in this case? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 1 day ago

Answer to Question posed by Dr Glassock is not really known --------------------------------- Bajinder Reen MD Etobicoke ON (905) 453-0821 -----...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 1 day ago

If the remission was "spontaneous" bc something was done, stopping eg lipoic acid , Hg (Nell1) NSAIAs, treating syphillis, Hepatitis, cancer, etc t...

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RE: What is the etiology 1 day ago

I would give 2 grams now, separated by two weeks for each gram, assuming that achieved remission and was steroid free, then I would give another si...

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RE: What is the etiology 1 day ago

Thank You Drs. Rodby and Glassock. What is the duration of Rituximab you recommend? ------------------------------ Asma Qayyum MD West Houston...

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Rituximab for "maintenance " of a CR in PLA2R related MN 1 day ago

What role , if any , does therapy with RTX play in prevention of relapses following a spontaneous or RTX /CYC induced complete clinical and immunol...

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RE: Comparison of CVVHD vs CVVHF on Dialyzer life span 1 day ago

Thanks a lot Prof.Teixeira Regards, Yassin ------------------------------ Ahmed Yassin MD, FASN Saudi German Hospital Madina ----------------...

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RE: Diffuse Lymphoid infiltrate on native kidney biopsy w/o lymphoproliferative disorder. 2 days ago

follow up: Seen today in follow up. Her serum creatinine, that peaked at 6 4 weeks ago is now 1.1. ------------------------------ Victor Gur...

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RE: Comparison of CVVHD vs CVVHF on Dialyzer life span 2 days ago

Hey Dr. Yassin -- Very good (and certainly controversial question). As already alluded to in the discussion, if doing CVVH with 100% post-filter re...

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RE: Comparison of CVVHD vs CVVHF on Dialyzer life span 2 days ago

Not to be picky, but I was comparing pure HF (CVVHF) with pure HD (CVVHD) and pure HD would have no "predilution", so I suspect you are talking abo...

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RE: What is the etiology 2 days ago

It is hard to put this all together but it is acting like a very steroid responsive podocytopathy, so responsive that by the time you biopsy the FP...

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RE: What is the etiology 2 days ago

Thank you for your response Dr. Glassock. Please see the attached documents. These are all the reports I have. ------------------------------...

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RE: What is the etiology 2 days ago

Thanks for the correction of the post. I can find no literature supporting a connection of eosinophilic esophagitis and MCD. The elevated IgE level...

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RE: What is the etiology 2 days ago

Thank you for bringing the april report to my attention. please find attached the edited reports. ------------------------------ Asma Qayyum ...

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RE: What is the etiology 3 days ago

Sorry, but the rules require that all identification of patient be redacted before a response can be Made, see the April 2025 Biopsy Report. ----...

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RE: Comparison of CVVHD vs CVVHF on Dialyzer life span 3 days ago

Thanks for reply Predilution decreases dialyzer clotting with both HF and HD modalities. I can conclude that larger molecules with HF have insig...

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What is the etiology 3 days ago

Hello everyone, I need help with a case. 65 white F with PMH of HTN, nephrotic syndrome, HLD, DM - 1c 6.6 (recently diagnosed), asthma, uri...

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What is the etiology 3 days ago

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RE: Complex SLE Case with Diffuse Alveolar Hemorrhage 3 days ago

"I recommend checking CRP, IL-6 , and ferritin levels. If markedly elevated, I would consider administering tocilizumab, while keeping in mind the ...

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RE: Diffuse Lymphoid infiltrate on native kidney biopsy w/o lymphoproliferative disorder. 3 days ago

I would do a chest/abd/pelvic CT to look for lymphadenopathy and splenomegaly. Another option is a PET/CT. You can also do a peripheral blood flow ...

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RE: Complex SLE Case with Diffuse Alveolar Hemorrhage 3 days ago

I would be very cautious about using GSCF in this fulminant inflammatory catasprophe. There is also a major risk of mortality from over Immunosuppr...

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RE: Complex SLE Case with Diffuse Alveolar Hemorrhage 3 days ago

I see, yes eltrombopag is for "ITP" and I dont think you can call this ITP in the setting of SLE. regardless as a thrombopoeitein receptor agon...

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RE: Complex SLE Case with Diffuse Alveolar Hemorrhage 3 days ago

I gave ravulizumab (long-acting complement C5 inhibitor ) last week, presuming there is element of TMA (see the original post) LDH has plateaued ...

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RE: Comparison of CVVHD vs CVVHF on Dialyzer life span 3 days ago

CVVHF hemoconcentrates the blood as it goes through the filter, but ONLY if you give the RF post filter. We always did CVVHF with pre filter RF b...

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RE: Complex SLE Case with Diffuse Alveolar Hemorrhage 3 days ago

I doubt the low WBC is disease activity, more likely the effect of the CYC. plex, steroids, CYC, ravulizumab, Rituximab, and now eltrombopag I'...

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RE: Complex SLE Case with Diffuse Alveolar Hemorrhage 3 days ago

Update Rituximab was given yesterday 20/April The patient remains intubated but the ventilator settings have improved for 2 days now ; however,...

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Comparison of CVVHD vs CVVHF on Dialyzer life span 3 days ago

Dear Respected Is there a considerable difference between impact of the modality of CVVHD and the modality of CVVHF regarding life span or clotti...

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RE: Advanced IgA Nephropathy 3 days ago

Thank you Dr Glassock, that's a great point. Ethan Orlev, MD FACP

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RE: Diffuse Lymphoid infiltrate on native kidney biopsy w/o lymphoproliferative disorder. 3 days ago

We recently saw a 77 y o lady with CLL, CKD III due to DM and HTN that developed AKI and became anuric requiring dialysis. The kidney biopsy can be...

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RE: Advanced IgA Nephropathy Sunday, April 20 @ 8:02 PM

I doubt that Sparsentan would result in harm, but the prospects for meaningful clinical benefit are low and uncertain. If BP became easier to contr...

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RE: Advanced IgA Nephropathy Sunday, April 20 @ 5:31 PM

Hi Dr Hirsch Thank you for your reply! I agree with you. The patient unfortunately is not very compliant. Would you even consider the Sparsentan ?...

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