RE: Positive genetic test for CFH gene 7 hours ago

Polymorphisms of CFH gene can be associated with senile macular degeneration , drusen and Geographuc atrophy. The latter can be treated with intrao...

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RE: Positive genetic test for CFH gene 47 minutes ago

She was referred due to persistently low GFR <60 and no clear etiology of CKD. We do genetic testing routinely now in all these patients. Her lipi...

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RE: Positive genetic test for CFH gene 49 minutes ago

Thank you 🙏 ------------------------------ Arshad Ali MD, FASN Munson Healthcare Cadillac MI (404) 536-6977 ------------------------------ [More]

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RE: Positive genetic test for CFH gene 50 minutes ago

GFR was T NM _ 000186.4:c.3628C>T (p.Arg1210Cys), Heterozygous, Classification: Likely Pathogenic This variant is predicted to result in a s...

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RE: Lab potassium normal range 1 hour ago

Very interesting developments: Results from surveying multiple large hospital laboratories found none using K NR 500K samples, he provided the ...

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RE: Hypercalcemia in a patient with SLE/MCTD 3 hours ago

Other drugs successfully (but rarely) used in the treatment of calcium homeostasis disorders are (hydroxy) chloroquine and ketoconazole. Both drugs...

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RE: Hypercalcemia in a patient with SLE/MCTD 4 hours ago

Tony: no apology needed! I misinterpreted what you had meant by SSA. In fact, I had thought of the possibility that my patient's MCTD may have incl...

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RE: Positive genetic test for CFH gene 5 hours ago

So this lady has normal renal function and the only 'problem' seems to be oval fat bodies in urine. I understand Dr Aledan's question as to why a g...

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RE: Hypercalcemia in a patient with SLE/MCTD 5 hours ago

My apologies I trid to fyoe in "@Venkat: and did not check what the system put in. Also pardon many typos. nAMD has impaired my visual acuity and I...

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RE: Hypercalcemia in a patient with SLE/MCTD 5 hours ago

@Anand Venkatraman I was not thinking Sjogren Syndrome. When I used SSA I was referring to sulfa salicylic acid, used to measure degree of protei...

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RE: Alport syndrome 5 hours ago

HCQ exerts a therapeutic effect through its anti-inflammatory and immunomodulatory effects in SLE and other rheumatoid conditions. HCQ reduces the ...

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RE: Alport syndrome 6 hours ago

Dear Professor Hayder Aledan, Thank you very much for your valuable suggestions. I have carefully reviewed the references you provided and will app...

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RE: Fibronectin Glomerulopathy 6 hours ago

Recent papers have described increasing success in slowing progression and reducing proteinuria with a combination of RTX and CYC This protocol sho...

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RE: Fibronectin Glomerulopathy 9 hours ago

Follow up on case. No response was seen after 3 months of RTX (1 gram 0 and 14 days) with increasing proteinuria, serum creatinine and decreasing s...

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RE: Alport syndrome 10 hours ago

You can try hydroxychloroquine which shows benefit in recent case series in children with X-linked Alport syndrome and persistent hematuria where H...

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RE: Positive genetic test for CFH gene 11 hours ago

What was the reason to send for genetic test despite normal RFT and UA? What was the type of genetic abnormalities (missense, deletion, …) Does the...

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RE: Hypercalcemia in a patient with SLE/MCTD 15 hours ago

I am thoroughly confused. Comes under your care and supposedly taking 50,000IU vit D and taking HCQ. Ca is on the low side and 25-OH vitD level [Mo...

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Positive genetic test for CFH gene 17 hours ago

How do you manage a 70 yr old female with stable renal function with serum creatinine at 1.12 with positive heterozygous CFH complement factor H de...

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RE: Hypercalcemia in a patient with SLE/MCTD 19 hours ago

@Anatole Besarab: In fact, as previously posted, only 1-25 dihydroxy vitamin D level was checked during hypercalcemia work-up and it was normal at ...

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RE: Hypercalcemia in a patient with SLE/MCTD 19 hours ago

Strange discrepancy between UACR/UPCR ratio.no explanation obvious With hypoalbuminemia and nephrotic range total urine protein excretion and negat...

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RE: Hypercalcemia in a patient with SLE/MCTD 19 hours ago

We have reached the point where we still do not understand the complex nature of her disease. We have left the issue of the hypercalcemia and as Dr...

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RE: Alport syndrome 19 hours ago

Dear Professor Richard Glossack, Thank you for your valuable suggestion. Under microscopy, the urine RBC deformation rate exceeds 80%. While persis...

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RE: Hypercalcemia in a patient with SLE/MCTD 21 hours ago

Update: Kidney biopsy results are shown below. To reiterate, her renal parameters preceding biopsy: 1. Urinalysis 1+ protein, no blood, no RBC or c...

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RE: Alport syndrome 1 day ago

I assume that no clots are seen and that lower unitary tract bleeding is not suspected . The nut cracker syndrome is a confounder here. Has cystosc...

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RE: ANCA with full house IF (?) 1 day ago

Thank you so much for the input on this case. I'll be updating this conversation once I get the results. I'm looking forward to get results. ...

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RE: ANCA with full house IF (?) 1 day ago

Thanks- if a Type III cryo is present thus would be compatible with Infective Endocarditis but not ANCA Vasculitis. If s Type II cryo is found then...

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Alport syndrome 1 day ago

‌Patient Demographics‌ ‌Gender‌: Female ‌Date of Birth‌: December 4, 2015 ‌Clinical Timeline & Key Findings‌ ‌December 14, 2017‌ ‌Chief Comp...

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RE: ANCA with full house IF (?) 1 day ago

Thank you again Dr Glassock, No hydralazine or any other known drugs that can cause ANCA Cryoglobulin still pending. C3 levels 101mg/dl ---...

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RE: ANCA with full house IF (?) 1 day ago

Thanks for the additional information. Does the patient take hydralazine.? Can you expedite the serology for the organisms mentioned. My suspicion ...

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RE: ANCA with full house IF (?) 1 day ago

Thank you Dr Glassock - I totally agree(!). I failed to mention the entire clinical picture: BC neg x2 , TEE neg for vegetation, ESR 0, no feve...

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RE: ANCA with full house IF (?) 1 day ago

This patient with Anti-PR 3 ANCA , low C 4, high RF , cardiac valve disease , colonic disease and a kidney biopsy with crescentic GN and ICGN must ...

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ANCA with full house IF (?) 1 day ago

58 y.o. male with a PMH significant for, colorectal cancer s/p resection and radiation, iron deficiency anemia, severe Mitral regurgitation and HTN...

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RE: Challenging Case C3GN 1 day ago

Sorry- We need the full report, not just a summary. It can be quite difficult to separate IRGN and C3GN on morphology . C3GN is a "pattern of inj...

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RE: Challenging Case C3GN 1 day ago

"Currently, the patient has 2+ proteinuria on dipstick and an increase in the urine albumin to creatinine ratio from 145 to 255 mg/g." Did he als...

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RE: Challenging Case C3GN 1 day ago

Thank you all for the prompt response. This is so appreciated. Below is the de-identified biopsy. Yes, I think monitoring off I/S will be the best ...

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RE: Challenging Case C3GN 1 day ago

The depressed C3 level seen in PIGN can be very short and therefore it is easily missed, unless serial levels are obtained weekly for at least 8-10...

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RE: Challenging case 1 day ago

A normal Rheurmatod factor level makes the possibility of Infective Endocarditis with kidney involvement in infection-related GN quite unlikely (th...

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RE: Challenging case 1 day ago

Wow! This is an open depiction and first time starting discussion from bottom ::::> the origin; instead of from the top downward : : : : >. from ...

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RE: Challenging case 2 days ago

Thank you Dr. Glassock and Dr. Rodby, I'll keep you updated. Dr. Abdalla I must admit with IgM predominant immune deposits endocarditis was high ...

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RE: Challenging case 2 days ago

Has the possibility of infective endocarditis been ruled out? --------------------------------- Alaa Nabih Abdalla nephrology fellow Egypt ----...

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RE: Challenging Case C3GN 2 days ago

forgot to attach ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associates Ch...

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RE: Challenging Case C3GN 2 days ago

My favorite article to attach these days echoes Dr Glassock's point C3G v PIGN can be difficult to tell apart. And yet I wonder that a normal c...

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RE: Challenging Case C3GN 2 days ago

Would it be possible to post the original kidney biopsy (, including LM, IF and EM, de-identified , of course)? . How can you be sure that thus is ...

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RE: Challenging case 2 days ago

I was aware of the concept but did not know that ASIA syndrome was it's name tattoos? https://onlinelibrary.wiley.com/doi/10.1002/978111985843...

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Challenging Case C3GN 2 days ago

Colleagues, I have a 20-year-old male with a diagnosis C3 glomerulonephritis in 2019 following an upper respiratory infection. At that time, the ...

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RE: Challenging case 2 days ago

Obviously , this must be Female Tattoo Disease (FTD). Just kidding. I have no idea what name to assign to this unusual constellation of findings. A...

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Challenging case 2 days ago

Dear colleagues, I'd like to receive your insight on this case. A woman in her 40s with history of abdominal pain, weight loss (now weighting abo...

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RE: lupus proteinuria 2 days ago

Prof.Ritchard, CNIs-voclosporin if affordable, tacrolimus otherwise-are first-line in isolated class V LN for three reasons. 1. Strong RCT signal: ...

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RE: Hypercalcemia in a patient with SLE/MCTD 2 days ago

IL-6 is the only cytokine that I know of associated with hypercalcemia. IL-6 is produced together with parathyroid hormone-related protein (PTH-rP)...

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RE: Hypercalcemia in a patient with SLE/MCTD 2 days ago

To summarize previous notes commentss. This is a case of a 45 y /o female carrying a diagnosis of SLE/MCTD for past 9 yrs .Rxment with hydroxychl...

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