RE: vasculitis anca 1 minutes ago

If your theory about no active disease was true then steroids would not improve things Also you don’t say how many glomeruli ? My understanding i...

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RE: vasculitis anca 10 minutes ago

Without avacopan --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: vasculitis anca 10 minutes ago

Many thanks dr shivangi What is her functional status and cognitive status? I assume no extra renal manifestation You have ruled out cancer with ...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 31 minutes ago

Thanks so the addendum refers to the radiologist, changing his interpretation of the MRI? and I suppose the neurologist changing what they believe ...

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Post-surgical renal cortical necrosis in APS - continue PLEX / eculizumab / IVIG, or de-escalate? 42 minutes ago

Looking for input on de-escalating therapy in a recovering APS-associated renal TMA / cortical necrosis case. Case: 66F with known antiphospholipi...

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RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 42 minutes ago

Fascinating. Thank you for sharing, Dr. Bleyer and look forward to reading more about this case as you gather further information - it might help u...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 51 minutes ago

Motor vehicle collision- the deficit happened when she was driving the MRI referenced in the ID consult was the original imaging from a week a...

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vasculitis anca 1 hour ago

Hi, I have patient with 75 yo female with htn hld afib on xarelto, hx of colon can s/p colectomy right, dvt pe with ivc filter2022 all same admissi...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 2 hours ago

Don't disagree with planned brain biopsy if the CNS imaging is now thought to be more consistent with a glioma. A little confused, was the infectio...

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RE: post infective vs C3 glomerulonephritis 3 hours ago

In my opinion, the finding of multiple subepithelial hump-like deposits by EM is insufficient to separate IRGN and C3GN. This finding can be observ...

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RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 4 hours ago

Thank you all for your answers! WE are exploring the core temperature issue by adjusting temperature at dialysis. Also, we are doing a metabolome b...

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RE: Resistant hypertension 4 hours ago

Thanks Dr. Glassock. I offered hospitalization but due to social reasons the patient was unwilling. She claims to be compliant with the meds. --...

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RE: Resistant hypertension 4 hours ago

Thanks Dr. Kesavan. Opthalmic evaluation revealed hypertensive Retinopathy with no papilledema. ------------------------------ Jaison George MD,...

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RE: Resistant hypertension 5 hours ago

Thanks Dr. Lerman. The tests were done prior to starting ARB, spironolactone and beta blocker. The patient claims to be compliant on drugs, and was...

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RE: Resistant hypertension 5 hours ago

Thanks What about urine hypertensive screen to check compliance? Can I ask why would long acting thiazide diuretic be preferred ? Many thanks ...

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RE: post infective vs C3 glomerulonephritis 10 hours ago

C4 stain was not done. Having focal proliferative GN not MPGN and Sub epithelial humps on EM is more consistant with PIGN ? ----------------------...

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RE: post infective vs C3 glomerulonephritis 14 hours ago

I agree with Drs, Venkat and Lerman the kidney biopsy finding of extensive global and segmental Glomerulosclerosis indicates that this process has ...

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RE: FSGS in patient with CML 15 hours ago

The lesion of FSGS is well recognized as a secondary complication of many myeloproliferative disorders, including CML. Dasatinib unfortunately is a...

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RE: post infective vs C3 glomerulonephritis 16 hours ago

Were cultures obtained prior to antibiotics? What was the dose of pulse steroids and how many? Biopsy suggest more than an acute process with c...

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FSGS in patient with CML 16 hours ago

Patient is a 44-year-old gentleman with a history of CML, gout, hyperlipidemia, and hypertension. Patient on referral was on Dasatnib for his CML. ...

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RE: Resistant hypertension 16 hours ago

I agree with Dr. Lerman that compliance is a significant concern. Why not hospitalize and give meds under direct supervision and begin to wean from...

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RE: Resistant hypertension 17 hours ago

More clinical data needed Building up of so many anti hypertensive agents covering all families ( except diuretics ), hormonal imaging studies ind...

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RE: post infective vs C3 glomerulonephritis 17 hours ago

Would measuring C3NeF be be of any value in separating C3GN from IRGN,? ------------------------------ Richard Glassock MD, FASN Emeritus Profess...

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RE: Resistant hypertension 17 hours ago

Microscopic hematuria most bothersome ? Dysmorphic HTN duration Family history Ophthalmic exam findings edema Coverage of all families of ------...

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RE: post infective vs C3 glomerulonephritis 18 hours ago

This serology is more compatible ti me with C3GN, but the presenting synptims are worrisome for an IRGN , antiDNAase antibidies are better than ASL...

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RE: post infective vs C3 glomerulonephritis 19 hours ago

Podocytes effacement was around 50% --------------------------------- Wael Jebur MD, FASN drwaellatif@hotmail.com Dubai ------------------------...

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RE: post infective vs C3 glomerulonephritis 19 hours ago

C3 C4 both were mormal, ASO titer is negative. IF showed predominant C3 deposition.All other markers were unremarkable. --------------------------...

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RE: Resistant hypertension 20 hours ago

, diagnostic tests in a patient like yours who has been prescribed multiple antihypertensive testing less accurate. Why have you not tried a long a...

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RE: C3GN with lambda light chains 22 hours ago

Thanks for case I was in biopsy meeting last week with histopathologist and she said sometimes the staining on IF are not always 100% accurate ( li...

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RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 23 hours ago

Dr Venturelli is absolutely correct in suggesting that cooling the core temperature may improve the symptoms of MG, this is a well-known phenomenon...

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Resistant hypertension 23 hours ago

Requesting opinion on the following case: A 42 year old lady presented with resistant hypertension her average home blood pressure was 180 /110 mm...

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RE: C3GN with lambda light chains 1 day ago

The lambda monoclonal paraprotein can interfere with the action of Factor H on C3 and lead to dysregulation of the alternate pathway of C activatio...

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RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 1 day ago

This patient has acetylcholine receptor antibody negative MG -maybe MuSK antibody. Changes in endogenous acetylcholine production would not likely ...

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RE: post infective vs C3 glomerulonephritis 1 day ago

"creatinine was stable at 3.5 mg/dl" Does this mean SCr remained stable around 3.5 mg/dL from time of admission? What was the extent of podocyte ...

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RE: C3GN with lambda light chains 1 day ago

Dr. Shah this is my opinion only can you provide the actual numbers for creatinine, GFR, 24 h proteinuria and serum C3, and intensity of C3, Igs...

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C3GN with lambda light chains 1 day ago

I have a 45 year old male patient with newly diagnosed CKD - long standing DM with over proteinuria. Work up revealed a lambda monoclonal band on S...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 1 day ago

Good that brain biopsy is planned. Autoimmune encephalitis less likely given chronic immunosuppression; infectious and neoplastic disorders much mo...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 1 day ago

Addendum: 7/3/26- latest ID note to answer Dr.Venkat's question and also update about this patient 27-year-old woman with congenital renal diseas...

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RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 1 day ago

Dr. Bleyer just a thought, is she on any kind of dialysate cooling for intradialytic hypotension? high body temperature is well known to worsen MG...

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RE: + MPO ANCA RLV case 1 day ago

Dr. Glassock In regards to the case of MPO + RLV Lab results have returned- The sedimentation rate and CRP were both normal. Recheck of other la...

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RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 1 day ago

Good point Dr. Venkat. In addition, she receives standard hemodialysis. I do not know where the High Flux story came from. This case remains quite ...

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RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 1 day ago

This patient's myasthenic weakness improves at the end of a 4hr HD session and deteriorates a few hours later. Yes, thiamine, B6, phosphorous, and ...

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RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 1 day ago

Given the unique kinetics of this case—where high-flux hemodialysis (HD) causes dramatic, transient clinical improvement while CRRT and PLEX do not...

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RE: post infective vs C3 glomerulonephritis 1 day ago

What was the patients serum C3 and C4 initially and during follow-up ?What were the anti-streptolysin O and antiDNase titers. Amy skin rashes prese...

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post infective vs C3 glomerulonephritis 1 day ago

I wanted to share this case with the community looking for your thought. 24-year-old male patient was admitted to the nephrology service with a d...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 1 day ago

Many thanks prof lerman and prof venkat --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 1 day ago

Dr. Kesavan -if the patient really has severe, disabling Myasthenia Gravis , why would these medications -supplements be of any benefit. I am not c...

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RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 2 days ago

Thiamine Pyridoxin B 12 mega doses neuro vitamins B complex supplements post HD Creatine supplement Keeping magnesium and phosphorus mildly posit...

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RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 2 days ago

Empiric treatment with carnitine? --------------------------------- Conjeevaram Kesavan MD, MBBS, FASN Duluth GA (678) 699-8521 ----------------...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 2 days ago

Sorry don't see an addendum ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pancre...

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