CMV IgM +/ CMV pcr neg. Recipient 27 minutes ago

I have one recipient his CMV status Ig M +/Ig G neg, his CMV pcr is negative. His donor ------------------------------ Ahmed Mahedy PhD Banha Fa...

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RE: lupus proteinuria 44 minutes ago

The options are to keep this combination of therapy (MMF, Belimumab and Prednisolone) plus one of the following: 1. Adding anti-CD20 drugs 2. Addi...

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RE: Persistant Hemoptysis In Anti-GBM 3 hours ago

I have update This patent Anti GBm After adding Rituximab First dose 12/3 anti GBM level never go to zero Last one 8. ( <20) u/ml) Still insist o...

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RE: Fibronectin Glomerulopathy 4 hours ago

See Sauvage G, et al KI Reports 2025;10: 944-947. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -------...

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RE: Fibronectin Glomerulopathy 4 hours ago

Thank you Dr. Glassock. What does protocol do you suggest? Continuous oral? EuroLupus? For how long? --------------------------------- Hayder Ale...

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RE: lupus proteinuria 10 hours ago

Dr. Alsaegh: Are statements #1 and #2 in your post correct for pure Lupus MN? Many contemporary trials exclude pure Lupus MN because of the very ...

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RE: Lab potassium normal range 11 hours ago

I have enjoyed this discussion, Ted, Thanks for bringing it up. Decades ago, when studying erythropoietin in ESRD, I tried to minimize costs for ...

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RE: lupus proteinuria 11 hours ago

I would like to add that both MMF and CYC (Euro Lupus style) were studied in the BLISS-LN trial, so belimumab doesn't need to be stopped if that is...

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RE: Positive genetic test for CFH gene 11 hours ago

allele frequency was not a useful indicator of pathogenicity since 2.3 percent of the general population bear one rare CFHvariant with an allele fr...

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RE: Positive genetic test for CFH gene 13 hours ago

An eGFR 45ml/min/1.73m2 without abnormal albuminuria (or proteinuria) is most likely a perfectly normal finding, in a female of this age - which ...

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RE: Lab potassium normal range 14 hours ago

Thank you Ted. I had previously posted the Gaussian curve of K level in ESRD patients from a previous publication. Nevertheless, yours is indeed an...

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RE: Positive genetic test for CFH gene 22 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 15 hours 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 15 hours 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 15 hours 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 16 hours 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 18 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 19 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 20 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 20 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 20 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 20 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 21 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 21 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 (?) 2 days 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 (?) 2 days 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 (?) 2 days 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 (?) 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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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