RE: MPO-ANCA Vasculitis in the Setting of Infective Endocarditis - Infection triggered mimic? 2 hours ago

difficult to differentiate between PIGN and AAV. the timing of the biopsy relative to diagnosis of BE may explain these atypical features. i ag...

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RE: MPO-ANCA Vasculitis in the Setting of Infective Endocarditis - Infection triggered mimic? 4 hours ago

Thank you Dr. Vito - below are biopsy details. BIOPSY DETAILS: Microscopic Description BIOPSY ADEQUACY: Cortex and medulla represented GLO...

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RE: IC mediated GN ??? or Lupus 14 hours ago

Technically , this patient does not conform to the standard criteria for a diagnosis of Lupus Podocytopathy or Class Ii/II/VLN ( or even MCTD) but ...

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RE: IC mediated GN ??? or Lupus 17 hours ago

I don't think of lupus podocytopathy (LP) as having to be an isolated lesion , it can occur on top of other lesions just like sub epithelial deposi...

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RE: IC mediated GN ??? or Lupus 19 hours ago

Quite hypoalbuminemic and hypercholesterolemic in keeping with a heavily proteinuric state. ------------------------------ K.K. Venkat MD Troy ...

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RE: MPO-ANCA Vasculitis in the Setting of Infective Endocarditis - Infection triggered mimic? 22 hours ago

Can you please provide the full description of te IF and EM? Best if you have an image of the EM. Any humps? ------------------------------ Vito ...

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RE: IC mediated GN ??? or Lupus 1 day ago

I dont have access to the pictures . However the final report of the biospy mentions : mesangial and capillary wall deposits by IF and EM and a f...

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RE: IC mediated GN ??? or Lupus 1 day ago

Dr. Dastoor: IMF report says biopsy is positive for granular epimembranous and capillary wall immunoreactants. This wording suggests extensive/glob...

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RE: IC mediated GN ??? or Lupus 1 day ago

I thought that the extent and distribution of immune deposits were too much for a Lupus Podocytopathy . The failure to respond the Steroids and Cyc...

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RE: IC mediated GN ??? or Lupus 1 day ago

what is best treatment for lupus podocytopathy associated nephrotic syndrome? ------------------------------ Wael Jebur MD drwaellatif@hotmail.c...

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RE: IC mediated GN ??? or Lupus 1 day ago

Seems to fit the picture of Lupus Podocytopathy ( see attached ) 1. LM:Normal Glomeruli or mesangial proliferation 2. IF : IC deposits predominan...

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RE: IC mediated GN ??? or Lupus 1 day ago

What may explain the nephrotic syndrome? Light microscopy is consistent with class II Lupus nephritis [ no proliferation, but only mesangial expans...

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RE: IC mediated GN ??? or Lupus 1 day ago

i would like to sincerely apologize for this misinformed thread the Sm antigen is negative and the SmRNP is positive with a strong titer Rest o...

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RE: IC mediated GN ??? or Lupus 1 day ago

Great case. Do you think there are too many subendo and subepi deposits to call this class II plus lupus podocytopathy over class III ? I am not...

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RE: IC mediated GN ??? or Lupus 1 day ago

My impression was the same , her positive ANA and Sm antigen along with the IF and EM , suggestive of lupus nephritis . However was not sure of the...

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RE: IC mediated GN ??? or Lupus 1 day ago

Agree with Dr. Glassock that this is most likely lupus nephritis. Were there tubuloreticular inclusions on EM? Not specific, but their presence wil...

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RE: MPO-ANCA Vasculitis in the Setting of Infective Endocarditis - Infection triggered mimic? 1 day ago

A rheumatoid factor level, if high, would sway me towards an infection related GN ------------------------------ Richard Glassock MD, FASN Laguna...

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RE: MPO-ANCA Vasculitis in the Setting of Infective Endocarditis - Infection triggered mimic? 1 day ago

The absence of hypocomplementemia make me a bit "nervous " about attributing this patients kidney disease entirely to the Infective Endocarditis bu...

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RE: MPO-ANCA Vasculitis in the Setting of Infective Endocarditis - Infection triggered mimic? 1 day ago

Rheumatoid factor? infection related gn can be paucimmune and can have a anca, I would assume this was all infection related and taper prednis...

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RE: MPO-ANCA Vasculitis in the Setting of Infective Endocarditis - Infection triggered mimic? 1 day ago

Thank you Dr. Glassock. The C3 and C4 were both normal (137 and 26 respectively). ------------------------------ Craig Hurwitz MD Northern Nephr...

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RE: Membranous Nephropathy 1 day ago

With the falling Salb and the slight rise in PLA2R antibody would redose with OBi now. ------------------------------ Richard Glassock MD, FASN L...

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RE: Membranous Nephropathy 1 day ago

The anti-PLA2R results are with ELISA Albumin 1.9 (5/2025) --> 2.1 (6/2025) --> 2.5 (8/2025) ---> 2.4 (10/12025 0 --> 1.9 (10/8/2025) ---------...

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RE: Membranous Nephropathy 1 day ago

With this much decline in Anti-PLA2R antibody levels , i dont think any more OBI is needed, Ut one more dose would not be harmful. Adding a CNI (sh...

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RE: IC mediated GN ??? or Lupus 1 day ago

I do not think that there is much doubt that this patient has SLE (ANA and anti Smith but Anti-dsDNA antibidy negative- by one assay if unknown typ...

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RE: MPO-ANCA Vasculitis in the Setting of Infective Endocarditis - Infection triggered mimic? 1 day ago

Difficult to be certain, but this case is behaving as an infection related necrotizing and crescentic GN that will likely improve with therapy of t...

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RE: cystic Kidney 1 day ago

Thank you Professor for your comment, I will also deepen my research on this diagnosis ------------------------------ Moussa Coulibaly DrMed CLIN...

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MPO-ANCA Vasculitis in the Setting of Infective Endocarditis - Infection triggered mimic? 2 days ago

I have a challenging case of a 79 year old healthy white male with ANCA-associated necrotizing glomerulonephritis (GN) occurring in the setting of ...

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IC mediated GN ??? or Lupus 2 days ago

I have a young 28 year old female from pakistan she states she was diagnosed with lupus back home and was treated with steroids and azatioprine ...

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RE: Membranous Nephropathy 2 days ago

Perhaps another round of OBI with a CNI may work better . If clinically nephrotic and hypoalbunemic with risk of DVT etc , u may want to get him in...

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RE: Membranous Nephropathy 2 days ago

You could check CD 19 but i think I would redose with obi regardless of results. Rituximab and cytoxan failure yet seems to have responded to obi...

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Membranous Nephropathy 2 days ago

44 year old Hispanic male with gout, HTN, hypothyroidism diagnosed with membranous nephropathy 8/2023 – KIDNEY, BIOPSY: - MEMBRANOUS NEPHROPATH...

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RE: Cystine stone and penicillamine 2 days ago

Thanks for the shout-out Roger. But I also want to acknowledge Dr Joe Crivelli, a prominent stone urologist who monitors this board for stone relat...

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RE: cystic Kidney 2 days ago

Thanks for clarifying liver cysts in: Dnajb 11 related renal disease which seems to be a clinical hybrid of ADTID (especially hnf1b ) and pkd2. ...

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RE: cystic Kidney 2 days ago

This case may harbor DNAJB11-associated disease. Kidneys are typically not enlarged and up to 40% can have liver cysts. CKD is typically late manif...

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RE: cystic Kidney 2 days ago

You're welcome Professor ------------------------------ Moussa Coulibaly DrMed CLINIQUE DURIEUX LE TAMPON 0033646599355 -------------------------...

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RE: cystic Kidney 2 days ago

Thank you Dr.Coulibaly. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

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RE: cystic Kidney 2 days ago

Of course Professor Glassock, I will send you a photo of this famous Piton de la Fournaise volcano whose last volcanic eruption took place in 2023,...

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RE: cystic Kidney 2 days ago

To my knowledge, this is the first (and only) Post we have ever received from the fascinating, exotic and picturesque Reunion Island. Thank you. If...

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RE: cystic Kidney 2 days ago

Okay, I will plan a genetic analysis as you recommend. Thank you so much Moussa COULIBALY Island Reunion ----------------------------...

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RE: cystic Kidney 2 days ago

No, the patient has no gout. I did not do a urinary uric acid dosage but I will dose it. Okay, I'm going to organize a genetic research. Thank yo...

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RE: Cystine stone and penicillamine 2 days ago

Following this train of thought I posted this on X (Twitter) a couple days ago https://x.com/nephrodby/status/1975938639788982622?s=46&t=O9pd_xBY...

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RE: cystic Kidney 2 days ago

Does the patient have gout, have you checked a UTI acid? AD tubukar interstitial disease should not affect the liver, but... Agree with genetic ana...

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RE: cystic Kidney 2 days ago

The lack of mother to child transmission (if ultrasound examinations for cysts are negative in the four children ) and the lack of renomegaly are p...

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RE: cystic Kidney 3 days ago

Yes, the patient has 4 children in their forties who have not yet been tested. I just asked the patient to ask her children to do an ultrasound. Th...

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RE: cystic Kidney 3 days ago

Does the patient have any children? Have they been tested for PKD (by ultrasound) ? By chance is the patient adopted. ? What is the level of kidney...

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RE: cystic Kidney 3 days ago

Thank you so much Prof Glassock for your response. ------------------------------ Moussa Coulibaly DrMed CLINIQUE DURIEUX LE TAMPON 003364659935...

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RE: cystic Kidney 3 days ago

Most likely ADPKD 2. A small percentage of such cases have no family history of PJD. I suppose that genetic testing might be indicated. Other opini...

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cystic Kidney 3 days ago

What are your diagnostic hypotheses? I have a 73-year-old patient, a non-smoker, who has recently discovered hypertension and has been experiencing...

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RE: Cystine stone and penicillamine 3 days ago

Like Dr Glassock, I wish to thank the discussants. I can remember less than a handful of patients who had cystinuria with stones in 50 years of pra...

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RE: Cystine stone and penicillamine 3 days ago

Great discussion. I have learned a lot of new things. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ---...

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