RE: Segmental Membranous Glomerulopathy with IgG1 Kappa Deposits 25 minutes ago

So @Nelson Leung, you are approaching this as an odd MGN not a MGRS? with that in mind what about watching her bc the proteinuria is so mild (1...

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RE: Fibronectin glomerulopath 41 minutes ago

You are right. I was thinking about nodular pattern GN.

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RE: Fibronectin glomerulopath 46 minutes ago

I do not think that a MPGN pattern of injury is seen in Idiopathic nodular glomerulisclerosis or In Diabetic Nephropathy . Please add some citation...

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RE: Intersting case-Need your opinion 56 minutes ago

aHUS can uncommonly co-exist with various other lesions, including LN, IgAN, C3GN, "Pauci Immune" non-ANCA Vasculitis and ICGN (including IRGN) It ...

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RE: dealing with CRS in ATG use as induction or treatment of ABMR 1 hour ago

The best approach is "preventive". In other words, NOT to forget to administer the pre-medication regimen when giving either polyclonal (i.e. ATG) ...

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RE: dealing with CRS in ATG use as induction or treatment of ABMR 1 hour ago

Also allergy / anaphylaxis can present like that therefore how to clinically differentiate ? --------------------------------- Muhammad Soobadar...

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RE: dealing with CRS in ATG use as induction or treatment of ABMR 2 hours ago

This patient infusion was stopped and restarted at lower rate and actually premedication was not given going through notes and he tolerated dose an...

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RE: dealing with CRS in ATG use as induction or treatment of ABMR 2 hours ago

many thanks this was what was described by colleague patient had a temperature spike of 38. patient seen - looks unwell. says he feels c...

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RE: Segmental Membranous Glomerulopathy with IgG1 Kappa Deposits 2 hours ago

Most of the masked IgGk deposits occur in young women. Most of these do respond quite well to rituximab. With increasing UACR, I would give that a ...

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RE: dealing with CRS in ATG use as induction or treatment of ABMR 3 hours ago

Please describe severity of your patients CRS Fever only ? Hypotension ? hypoxemia ? ------------------------------ [Mark] [Lerman] [MD,FASN...

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RE: Fibronectin glomerulopath 4 hours ago

Yes, EM will really help in the diagnosis of fibronectin GN (giant mesangial and subendothelial deposits). Other considerations for MPGN pattern GN...

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RE: Intersting case-Need your opinion 10 hours ago

I would go for a Primary TMA (CM -aHuS) and perhaps continue eculizimab . The presence of thrombi within glomeruli is highly suggestive of a Primar...

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RE: severe hyperparathyroidism (PTH 6745) and hyperphosphatemia 10 hours ago

My error- REGULAR Dr, Pepper contains about 150mgP per liter or 1.3 Gms /d at 24 12 ounce cans per day. Also dark brown color soda is not a reliabl...

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Intersting case-Need your opinion 10 hours ago

Dear all, I have 33 year old presented with central chest pain. She just started BP meds 4 days prior. BP was 177/92 at admission. Social Hx:SH - ...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 10 hours ago

Thanks prof glassock . Point noted Can I make another suggestion - do you know if this could be extra renal vasculitis . I will attach a photo of...

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RE: dealing with CRS in ATG use as induction or treatment of ABMR 10 hours ago

Thanks prof venkat . Cytokine release syndrome --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: severe hyperparathyroidism (PTH 6745) and hyperphosphatemia 11 hours ago

The phosphorous content of Regular Dr. Pepper is approximately 100mg /L. 24 cans (12 ounces each) = 288 ounces = 8.6 L Or excess PO4 of 860mg/d.. H...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 12 hours ago

fda.gov/drugs/drug-safety-and-availability/fda-identifies-cases-serious-liver-injury-patients-taking-tavneos-avacopan-severe-active-anti ---------...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 12 hours ago

If the EMA does not withdraw the drug , we are allowed to use it , regardless of FDA decisions --------------------------------- Dr. Hormaz Dastoo...

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RE: severe hyperparathyroidism (PTH 6745) and hyperphosphatemia 13 hours ago

Soda Nephropathy similar to Mesoamerican nephropathy I have seen AKI in a 39 yo white man a constructer consuming a case of regular Coca Cola sod...

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RE: Fibronectin glomerulopath 13 hours ago

Thanks Dr Glassock, Dr Schwartz for the reply. The pathologist opined FNG based on nodules being PAS+ & red on MT. There is no facility to do IHC f...

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RE: dealing with CRS in ATG use as induction or treatment of ABMR 14 hours ago

What does "CRS" refer to in this post? Cardio-renal syndrome? Can you please provide more clinical details of the case? -------------------------...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 14 hours ago

"U A:C 44mg/mmol 17/4, P:Cr 273ml/mmol" UAlb concentration one/sixth of total protein in (? same sample) of urine. This favors a tubulointerstiti...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 14 hours ago

I do not believe that this patient had MPO + Vasculitis to begin with. probably a false + anti-MPO with infection related AKI. Very diffucult ri pr...

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RE: severe hyperparathyroidism (PTH 6745) and hyperphosphatemia 15 hours ago

I have seen AKI in a kidney transplant recipient due from drinking large quantities of a phosphate-rich soft drink. However, especially if this pat...

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RE: severe hyperparathyroidism (PTH 6745) and hyperphosphatemia 16 hours ago

The kidneys are 9.3 and 9.5 cm. He says his father has some issues with his kidneys but he is pretty estranged from him so details are scarce. Yes ...

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RE: severe hyperparathyroidism (PTH 6745) and hyperphosphatemia 16 hours ago

What is the kidney size by US.? No prior serum creatinine value, I presume. This is very likely very chronic (and irreversible) disease. I doubt th...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 17 hours ago

In patients who have had cyclophosphamide infusion for vasculitis and on pcp prophylaxis and also avacopan ( understand issue with fda currently bu...

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dealing with CRS in ATG use as induction or treatment of ABMR 17 hours ago

how do colleagues manage this issue? do we continue infusion as slower rate? or stop infusion and try next day? ATG (Anti-thymocyte Globulin) – ...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 17 hours ago

question is can plex with cyclo/steroids and avacopan in 10 days normalise kidney histology? ( forgot to add plex) i guess answer is no. avacopa...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 17 hours ago

Specimen Type: Native renal biopsy Clinical Details: Directly entered by electronic request:Renal biopsy - anca vasculitis vs other cause. Macr...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 17 hours ago

thanks prof rodby a bit of contex to the case( summary she has been on ward atleast 5 weeks and i am picking her up after first ward review 58 ...

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severe hyperparathyroidism (PTH 6745) and hyperphosphatemia 18 hours ago

I have a patient who presented with no medical care in his adult life, in his mid 30's, who consumes 12-24 Dr Peppers daily. He has a BUN > 150 (hi...

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RE: Crescentic GN With Raised Anti-GBM But No Immune Deposit 19 hours ago

Thank you prof Glassock and Dr Dastoor, Our histopathologist confirmed that there were viable gloms on IMF and they always run control tissue. ...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 20 hours ago

Vanishing Bile Duct Syndrome (VDBS) is a rare disease having a global distribution ( neither I nor my AI assistant -Claude- recognizes any data ind...

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RE: SIADH conundrum 20 hours ago

Thanks Qais. Hope you are well. I don't get to NYC much anymore as my daughter moved to DC. Hope we can catch up one of these days. Best wishes W...

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RE: Post Partum TMA 22 hours ago

Thanks. pt/aptt normal. After timing the the first dose of Ravi- she stopped hemolyzing a few hours after it was given but assume it was trendi...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 22 hours ago

If Avacopan is withdrawn in the USA by an FDA action calling the data insufficient (or unreliable) to demonstrate efficacy (and with comments on po...

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RE: Crescentic GN With Raised Anti-GBM But No Immune Deposit 22 hours ago

A very complex issue. Only three possibilities exist. 1) the serum anti-GBM assays are "falsely positive ". With modern ELISA or chemiluminescence ...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 23 hours ago

In case of IgA we have some weak Chinese data the E1 lesions regress within 3-6 months with steroids , but M1 lesions take longer than 12 months , ...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 23 hours ago

We have used Avacopan , without any hepatoxiicity in our patients .. there is a higher incidence of Vanishing bile duct syndrome in the Japanese po...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 23 hours ago

We do not have a great deal of serial kidney biopsy information in ANCA Vasculitis and virtually none at 10 days after starting therapy . I agree w...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 1 day ago

10 days is way too soon for histologic resolution of ANCA vasculitis. What was the clinical presentation? Anca Elisa, pattern, hematuria, protein...

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RE: SIADH conundrum 1 day ago

Yes. Great to hear from you ------------------------------ Eric Neilson MD, FASN Northwestern University Chicago IL (312) 503-0340 --------------...

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RE: SIADH conundrum 1 day ago

Thank you Qais. It must be an excellent APP as it incorporates the traditional formula (see below). LOL My primary concern with these application...

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RE: SIADH conundrum 1 day ago

Eric Daniel's app is called Water and Sodium Formulas in the App Store ------------------------------ Qais Al-Awqati MBChB Columbia University N...

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Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 1 day ago

Dear colleagues , One dose of cyclophosphamide , 3 pulse methylprednisolone , and avacopan in mpo positive patients then kidney biopsy normal after...

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RE: Segmental Membranous Glomerulopathy with IgG1 Kappa Deposits 1 day ago

I agree with Dr. Glassock first reply and choice of anit-CD38 monotherapy. Rituxan is likely not to be effect. Even if BM biopsy is negative, extra...

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RE: MPGN with negative IMF 1 day ago

The absence if fibrils by EM makes Fibrillary GN unlikely. Can you stain the biopsy for Fibronectin deposits? ------------------------------ Rich...

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RE: MPGN with negative IMF 1 day ago

Her chronic med list includes: Amlodipine, calcium carbonate+vit D combination tablet, glucosamine, prazosin, simvastatin, valsartan, vit B complex...

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