Management of Sjögren's syndrome with type II cryoglobulinemic MPGN in the absence of a confirmed lymphoproliferative disorder 2 hours ago

I would greatly appreciate your opinion regarding the management of the following challenging case. A 42-year-old woman presented with fever, fat...

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RE: 3rd Generation Gadolinium Use In Pt With CKD IV/V 4 hours ago

Thanks , appreciate the advice --------------------------------- Aymen Al-Duajili MD Gulf Coast Nephrology Sugar Land TX (832) 526-1343 ------...

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RE: 3rd Generation Gadolinium Use In Pt With CKD IV/V 4 hours ago

let look at this from another perspective-agree with doing MRI with gadolinium using newer generations ( we all agree risk is low) but consequences...

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RE: anti gbm serology postive with fever and raised inflammatory markers 5 hours ago

I assume linear IgG on biopsy. With oliguria , nearly 100% glomerular crescents and dialysis dependency his prognosis for recovery of useful renal ...

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RE: 3rd Generation Gadolinium Use In Pt With CKD IV/V 6 hours ago

I basically agree with Dr. Rodby. For what it's worth, we have an institutional policy on this and we do not initiate dialysis on a patient to dial...

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RE: anti gbm serology postive with fever and raised inflammatory markers 6 hours ago

Anti-GBM antibody disease can present with fever in the elderly patient with a poor prognosis. Will find a paper and post it. --------------------...

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RE: 3rd Generation Gadolinium Use In Pt With CKD IV/V 15 hours ago

The vast majority of the nephrology community does not believe that there is any appreciable risk to the newer Gad compounds. And while Gad is dial...

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RE: anti gbm serology postive with fever and raised inflammatory markers 19 hours ago

await IF and EM prior to stopping Plex. continue dialysis unless uo improves and evidence of intrinsic renal function. If any viable glomeruli (whi...

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RE: anti gbm serology postive with fever and raised inflammatory markers 19 hours ago

Thanks prof lerman You would not immunosuppress stop steroid and plex and plan for dialysis? --------------------------------- Muhammad Soobada...

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RE: anti gbm serology postive with fever and raised inflammatory markers 19 hours ago

"All renal screen negative . Cryoglobulin not sent ( complement normal )" per DR. Soobadar .IF REPEAT ANTI-GBM still high-then not likely infection...

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RE: anti gbm serology postive with fever and raised inflammatory markers 19 hours ago

C3/c4 normal Histopathologist felt inflammatory changes in glom leads to tin Not concerned about infection IF and degree of chronicity awaited to...

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RE: anti gbm serology postive with fever and raised inflammatory markers 19 hours ago

"significant glomerulitis": Does this mean endocapillary cellular infiltration ("exudative GN")? Especially, if there are abundant endocapillary ...

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RE: anti gbm serology postive with fever and raised inflammatory markers 20 hours ago

and is daily plex or alternate day plex? ------------------------------ Muhammad Soobadar MBChB UK ------------------------------

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RE: anti gbm serology postive with fever and raised inflammatory markers 20 hours ago

patient had biopsy yesterday and plex today with octaplas and albumin. we need to remove femoral line tomorrow and insert temporary jugular line. ...

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RE: anti gbm serology postive with fever and raised inflammatory markers 20 hours ago

provisional histopathology report Notes LM- florid crescentic necotising GN almost all glomeruli glomerular tuff show significant glomeru...

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RE: Lupus planning pregnancy, now with low C3/C4. 23 hours ago

would think of patient as whole . If kidney biopsy is negative for LN but complement have gone done ds dna up and extra renal manifestation of lupu...

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RE: Lupus planning pregnancy, now with low C3/C4. 1 day ago

I would be interested to know your thoughts on advising her if she undergo a kidney biopsy and that was negative for LN? Would you recommend that s...

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3rd Generation Gadolinium Use In Pt With CKD IV/V 1 day ago

Dear colleagues I have a pt with progressive diabetic CKD IV/V, baseline cr 3.2-3.5, gfr 14-16, proteinuric Head ct scan showed left parietal lobe...

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RE: Lupus planning pregnancy, now with low C3/C4. 1 day ago

i think if she proceeds with pregnancy-you must monitor UPC, SEDIMENT, RENAL FUNCTION(CREATININE) OFTEN AT LEAST EVERY 2 WEEKS. could add CNI ,cont...

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Apply to Participate in the ASN FIT Bowl at Kidney Week 2026 1 day ago

Hi All, Test your knowledge against your peers! Win ultimate bragging rights at Kidney Week! Join the American Society of Nephrology (ASN) F...

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Encourage Your Fellows to Participate in the FIT Bowl at Kidney Week 2026 1 day ago

Encourage your fellows to join the American Society of Nephrology (ASN) Fellows-in-Training (FIT) Bowl at Kidney Week 2026 in Denver, CO. This year...

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RE: Colleague Managing Home Hd Cohort 1 day ago

Thanks a lot --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

Thanks prof lerman will definitely post as soon as available Best wishes --------------------------------- Muhammad Soobadar MBChB UK ---------...

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RE: Lupus planning pregnancy, now with low C3/C4. 1 day ago

7( continue to try pregnancy ) --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Lupus planning pregnancy, now with low C3/C4. 1 day ago

Interested with what you would do 1You would go back to mmf and steroids ? 2 mmf and steroids / do a biopsy and if class IV add obi 3 mmf and ster...

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

Creatinine roughly 1.10 in your neighbourhood 👍🏼 --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

Dr. Soobadar-thanks-renal biopsy hopefully will clarify if ARF is reversible - please share results ------------------------------ [Mark] [Lerman...

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

-TOE Result today . Challenging case for T-TEER. Although the TR originates from a favourable location, the imaging windows are compromised due to ...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

@ Prof lermann thank really helpful . patient had methy pred , biopsy pm and dialysis and tomorrrow plex anuric since coming to renal ward. ...

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RE: Lupus planning pregnancy, now with low C3/C4. 1 day ago

Agree you are playing with fire, The bigger issue is how DO you get her into remission tat will last longer that she can get through pregnancy. ...

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RE: anti gbm serology postive with fever and raised inflammatory markers 2 days ago

Initially oliguric, now anuric. Any urinalyses available from either the peripheral hospital or your institution? Blood culture positive for coag...

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RE: Lupus planning pregnancy, now with low C3/C4. 2 days ago

I too strongly feel this lady is likely to have adverse pregnancy outcomes due to worsening immunological activity which may predate a clinical rel...

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RE: anti gbm serology postive with fever and raised inflammatory markers 2 days ago

Looking at this from the other side, how confident are you in the diagnosis of urinary tract infection? Your positive culture was for CONS which is...

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Applications for ASN ITE Committee Now Open 2 days ago

Dear Kidney Educators, Thank you for your continued commitment to training in nephrology. The American Society of Nephrology (ASN) In-Training Ex...

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RE: Lupus planning pregnancy, now with low C3/C4. 2 days ago

I asked my AI colleague (Claude) to opine on this case. He agreed that with the history of ClassIV LN and the the recent changes in serology implyi...

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RE: Lupus planning pregnancy, now with low C3/C4. 2 days ago

YES, uncommon but anyone who sees cases of LN frequently can remember a case or two. If she becomes pregnant it will be difficult but a successful ...

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RE: anti gbm serology postive with fever and raised inflammatory markers 2 days ago

probably not as its immunosuppression which increases risk with serious infection. Plex is not indicated in simultaneously dialysis-dependent at pr...

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RE: anti gbm serology postive with fever and raised inflammatory markers 2 days ago

Thanks both Guess kidney biopsy will help us here . Is there harm to plasma exchange if this turned out to be infection related ? And if harm in ...

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RE: anti gbm serology postive with fever and raised inflammatory markers 2 days ago

All renal screen negative . Cryoglobulin not sent ( complement normal ) Virology negative Methyl pred - biopsy and if delay for results start ple...

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RE: anti gbm serology postive with fever and raised inflammatory markers 2 days ago

Dr. Lerman is correct bacterial sepsis, including urosepsis, can cause anti-GBM formation and possibly to glomerular disease. Rare, but I have seen...

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RE: anti gbm serology postive with fever and raised inflammatory markers 2 days ago

AGREE WITH PLAN- but would repeat and confirm the anti-GBM titre on a fresh sample in a reference lab, and send MPO/PR3-ANCA, ANA, complements C3/C...

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RE: Lupus planning pregnancy, now with low C3/C4. 2 days ago

This patient needs triple therapy for active LN and should avoid pregnancy. Contraceptives are indicated. ------------------------------ Richard ...

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RE: Latent TB and Membranous Nephropathy 2 days ago

thanks prog glassock will bring it as paper in journal club for discussion hopefully can change practice. ------------------------------ Muham...

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RE: anti gbm serology postive with fever and raised inflammatory markers 2 days ago

and if biopsy result delayed will start plex and wait for biopsy result to come back . does that sound ok? @prof glassock your input valued ---...

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anti gbm serology postive with fever and raised inflammatory markers 2 days ago

74 m bg HTN and usually fit and well baseline egfr 56 m/min Admitted inextremis with aki 3, oliguria , hyperkalaemia ,acidosis and raised inflamm...

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ASN FIT Bowl 2 days ago

We have 3/4 fellows from Harbor-UCLA hoping to participate in the FIT Bowl at ASN this year, we are looking for one more fellow to join so we can f...

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Lupus planning pregnancy, now with low C3/C4. 3 days ago

30 year old significant for Hypothyroidism, SLE with history dating back to 2015 ,Renal Biopsy done with results of lupus nephritis classs III and ...

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RE: PLA2R negative Membranous Nephropathy- Management Q 3 days ago

Thanks. Good discussion. The current FDA endorsed pivotal Phase 3 Trial of Felzartamab in MN uses CNI as a comparative arm , not OBI so it will not...

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RE: PLA2R negative Membranous Nephropathy- Management Q 3 days ago

@Richard Glassock: Is there more information that you are aware off about the Trillini cohort. Few things are missing for me to make heads or tails...

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RE: PLA2R negative Membranous Nephropathy- Management Q 3 days ago

Trial of Felzartamab against Obinutuzumab has to be designed with non-inferiority endpoint. Companied do not like to conduct such trials. A double ...

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