RE: Full House/Non Lupus nephropathy 2 hours ago

Most large studies have demonstrated great difficulty is separation C3G and "so called " Primary IC-MPGN into discrete "entities". I agree with San...

View Discussion

RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 3 hours ago

The issue is one of safety of RTX, in the face of continued HBsAg positivity in a patient with HBV infection under therapy with Entacavir. . Do you...

View Discussion

RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 3 hours ago

With the PLA2R titer and proteinuria more than 8g still, probably falls under the high risk category and would warrant immunosuppression with RTX. ...

View Discussion

RE: MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 8 hours ago

Dear all!! Thank you all very much for these thoughtful and extremely helpful suggestions. I truly appreciate the time and expertise you have ...

View Discussion

RE: Rituximab, Membranous Nephropathy, and Isolation in a Prison Setting 9 hours ago

No need for isolation of a patient with MN under therapy with RTX, unless HBV-DNA positive and thus possibly a vector of HBV infection, --------...

View Discussion

RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 10 hours ago

Active hep b is linked to MN --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 10 hours ago

Active hep is linked to mn then maybe treat hep B first and see and if no improvement maybe kidney biopsy before rituxan ( just a humble opinion ) ...

View Discussion

Rituximab, Membranous Nephropathy, and Isolation in a Prison Setting 10 hours ago

For a prisoner with membranous nephropathy who is being treated with rituximab, is isolation required solely because the patient received rituximab...

View Discussion

RE: Proteinuria and hematuria in 2 siblings 12 hours ago

I think this is genetic FSGS in both siblings. The absence of hypoalbuminemia makes Primary FSGS very unlikely. About 10-15% of patients with genet...

View Discussion

RE: Proteinuria and hematuria in 2 siblings 12 hours ago

I agree this is secondary FSGS based on pathology and on no edema Would have predicted a COL4 a3-5 but that is not supported by the genetic studi...

View Discussion

Proteinuria and hematuria in 2 siblings 12 hours ago

A 45-year-old male (Italian descent) was initially evaluated for proteinuria 10 years ago (at age 35) he also had microscopic hematuria. The protei...

View Discussion

RE: MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 13 hours ago

From what I remember it's needed to make the diagnosis, but I've seen a very few patients with this condition. I don't know if screening for subcli...

View Discussion

RE: MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 13 hours ago

Interesting idea. Without any overt polyneuropathy can a diagnosis of POEMS syndrome really be entertained? Just curious. -----------------------...

View Discussion

RE: is it SIADH 14 hours ago

Dr. Rodby said uric acid levels useful as tiebraker, as I previosly said serum uric acid < 4 and or high FE- Urate favors SIADH. ---------------...

View Discussion

RE: MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 14 hours ago

The presence of MPGN/TMA, an IgA monoclonal protein, pleural effusion and thrombocytosis make kidney involvement secondary to POEMS syndrome an imp...

View Discussion

RE: MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 14 hours ago

Mesangial expansion, lobular accentuation -sounds like MPGN pattern of injury . What did the silver-methenamine stain show.- how many double contou...

View Discussion

RE: is it SIADH 15 hours ago

And prof lerman --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: Full House/Non Lupus nephropathy 15 hours ago

Are you dealing with Full house Lupus ( seronegative as in your cases) ,or , Full house non lupus nephropathy ( C1q, MPGN, membranous, IgA , po...

View Discussion

RE: is it SIADH 15 hours ago

Thanks really helpful for some concepts that I struggle prof mellas / rodby / dr dastoor I will watch video Patient told me today he felt the l...

View Discussion

RE: is it SIADH 15 hours ago

Not to confuse either , using a primary assessment of volume status in " Euvolemic " hyponatremia , is tricky . A distinction between " euvolemic...

View Discussion

RE: is it SIADH 16 hours ago

not trying to confuse things Pt is euvolaemic however anti-diuretic hormone is inappropriately secreted. Euvolemia vs mild hypovolemia and be v...

View Discussion

RE: MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 17 hours ago

@Patricia D' Almeida Bianco: Was there any glomerular capillary wall duplication? Did this patient show thrombocytosis at anytime in the setting of...

View Discussion

RE: Full House/Non Lupus nephropathy 19 hours ago

Thank you Dr Rodby and Glassock Thank you for the articles, have read them. ------------------------------ Sandeep Magoon MD Nephrology Associ...

View Discussion

RE: C3 or MGRS 1 day ago

The IgM paraprotein suggests a lymphocytic rather than a plasma cell clone. ------------------------------ Richard Glassock MD, FASN Emeritus Pro...

View Discussion

RE: is it SIADH 1 day ago

@Muhammad Soobadar If you have 90 minutes free time , I suggest you review this lecture , which should answer all ( majority) your questions on hy...

View Discussion

RE: C3 or MGRS 1 day ago

Dr. Glassock, can you elaborate on why you would consider anti CD20 therapy over antiCD38 for a diagnosis of PGNMID. --------------------------...

View Discussion

RE: MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 1 day ago

The absence of EM in this case is a significant deficiency that might be remedied by out-sourcing the kidney biopsy material. This is also a classi...

View Discussion

RE: Refractory membranous Nephropathy 1 day ago

OBI does not treat immunologically inactive disease with GBM remodeling. No surprise. This is not immunologically refractory MN. Just an opinion. ...

View Discussion

RE: Refractory membranous Nephropathy 1 day ago

We did try obi x 2 doses in April. No response at all. --------------------------------- Dr. Hormaz Dastoor. MD, MSc, FASN Divisional Head of Nep...

View Discussion

MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein 1 day ago

MPGN pattern in a 43-year-old woman with a JAK2-positive hematologic disorder, portal hypertension, and a serum IgA-λ monoclonal protein I would a...

View Discussion

RE: is it SIADH 1 day ago

Alcohol excess can cause hyponatremia through several mechanisms, the most characteristic is beer potomania (solute-limited water excretion) and va...

View Discussion

RE: pr3 +ve is it endocarditis ? 1 day ago

Urine dipstick positive for blood and protein --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: pr3 +ve is it endocarditis ? 1 day ago

Crp mid 20 --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: pr3 +ve is it endocarditis ? 1 day ago

Creatine 1.10 Urine acr 0.5 g --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: is it SIADH 1 day ago

Why would urine (na +k ) 133 be in keeping with SIADH ? interested to learn According to prior research published by Edelman a simplified equati...

View Discussion

RE: C3 or MGRS 1 day ago

I am coming to believe that Sanjeev Sethi is correct- Idiopathic (Primary ) IC -MPGN and C3GN are very uncommon "diseases"- best regarded as "patte...

View Discussion

RE: is it SIADH 1 day ago

Does nephrostomy trigger ADH? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: is it SIADH 1 day ago

@ dr dastoor he is undernourished hit nail on head How does alcohol excess cause hyponatremia? Due to weight loss I have requested whole body CT...

View Discussion

RE: is it SIADH 1 day ago

- Why would urine (na +k ) 133 be in keeping with SIADH ? interested to learn . Please correct me if am wrong If hypovloaemic hyponatremia then ...

View Discussion

RE: C3 or MGRS 1 day ago

I think this is a case of PGNMID - IgM kappa. . . I would treat with RTX or OBI first. Later maybe with Bendamustine , with Hematology approval. Ju...

View Discussion

RE: Refractory membranous Nephropathy 1 day ago

I do not think this is likely to be refractory MN, but is due to chronic remodeling offpermselectivit barrier. You could try OBI but I doubt it wil...

View Discussion

RE: Suspected COL4 related disease 1 day ago

Alport syndrom withou hematuria is uncommon but can occur. With Obesity, would definitely consider SGLT2i and GLP1RA. ---------------------------...

View Discussion

RE: Full House/Non Lupus nephropathy 1 day ago

Idiopathic IC-MPGN is very rare, if it exists a at all. Over age 50 it is usually a missed diagnosis of PGNMID ------------------------------ Ri...

View Discussion

RE: C3G Or FSGS 1 day ago

Great case and good clinical results. Congrats, C3 is just a passive bystander here. Give OBI when he relapses. ------------------------------ R...

View Discussion

RE: Full House/Non Lupus nephropathy 1 day ago

From CJASN 19: 743–754, 2024 (also attached) "Nonlupus full house nephropathy is addressed by many different names in the literature." I ha...

View Discussion

Full House/Non Lupus nephropathy 1 day ago

Hello Colleagues Question for the group. I have 2 patients 1. Hispanic male 56, saw a couple of years back with nephrotic range proteinuria a...

View Discussion

RE: is it SIADH 1 day ago

The question here is how we define SIADH Is it Uosm> 100 mosm/kg , in presence of euvolemic hyponatremia or , is it Uosm > Posm , as per Eu...

View Discussion

RE: Suspected COL4 related disease 1 day ago

I don't have the dipstick result but there was no red cell on any specimen..her BMI is 32 kg/m2 ------------------------------ Safa Nowrooz MD Dr...

View Discussion

RE: C3 or MGRS 1 day ago

Just to give a follow up on the case . The patient was first diagnosed with a MPGN pattern of injury , and Kappa restriction on IF . EM showed si...

View Discussion

RE: Refractory membranous Nephropathy 1 day ago

Just as a follow up and seeking further advice on this case , This patient with MN has turned antiPLA2r negative since 2023 , has also been TH...

View Discussion