RE: Urgent: ASN Must Advocate for Dr. Rasha Alawieh's Re-Entry to the U.S 7 hours ago

Well said Joel. With all the happenings in the last few weeks - the silence from leadership at institutions and organizations has been deafening. ...

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Urgent: ASN Must Advocate for Dr. Rasha Alawieh's Re-Entry to the U.S 8 hours ago

Dear Prabir Roy-Chaudhury and the ASN Leadership, I am writing to express deep concern over the case of Dr. Rasha Alawieh, a highly respected 34-y...

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RE: Hypokalaemia 10 hours ago

Urine: chloride <20, uOsm 611, uNa <20, uK 95, uCreat 39.9 Note: U Cl reported as < 20 suggesting the complete absorption of all NaCl which must ...

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RE: Hypokalaemia 14 hours ago

I have another view of this complex and interesting case. A few years of polyuria, nocturia and incontinence may suggest hypokalemia is the main d...

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RE: Relevance Of Ds DNA Positivity With Negative Ana And Normal C3/c4 22 hours ago

Thanks everyone really helpful --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Relevance Of Ds DNA Positivity With Negative Ana And Normal C3/c4 1 day ago

That's an astute thought Dr Salman. There does seem to be cross reactivity between antibodies to bacterial dsDNA and calf thymus dsDNA. The latter ...

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RE: Relevance Of Ds DNA Positivity With Negative Ana And Normal C3/c4 1 day ago

Do bacteria have double stranded DNA? " Yes, bacteria, like other organisms, utilize double-stranded DNA (dsDNA) as their genetic material, typi...

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RE: Relevance Of Ds DNA Positivity With Negative Ana And Normal C3/c4 1 day ago

This is endocarditis related gn with autoimmune markers until proven otherwise, did you by chance get a Rheumatoid factor? It is not false positive...

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RE: Relevance Of Ds DNA Positivity With Negative Ana And Normal C3/c4 1 day ago

I think she has TINU or Behçet's Dz triggered by a serious infection + endocarditis. It appears that broken DS-DNA particles exposed by the injur...

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RE: Hypokalaemia 2 days ago

Urine: chloride <20, uOsm 611, uNa <20, uK 95, uCreat 39.9 Renin/aldosterone ratio 48 and 61 The low U Na and K and elevated U som needs o be exp...

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RE: Hyponatremia 2 days ago

As Dr Rodby said about NSAIDs (a million takers, almost no hyponatremia), the same could probably be said about RASIs and thirst. Her low GFR wil...

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RE: Relevance Of Ds DNA Positivity With Negative Ana And Normal C3/c4 2 days ago

Anti- ds DNA antibodies (as well as ANCA and very rarely antiGBM antibodies) can be observed in infective endocarditis. They usually disappear with...

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RE: Hyponatremia 2 days ago

I assume she has no DM and her RBS is normal as hyperglycemia can cause thirst. If Hyponatremia was due to NSAIDs, it may be associated with hyper...

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RE: Relevance Of Ds DNA Positivity With Negative Ana And Normal C3/c4 2 days ago

I will try to learn the American Way of writing dates . Sorry for inconvenience Best wishes --------------------------------- Muhammad Soobadar ...

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RE: Hypokalaemia 2 days ago

Urine osmolal gap is almost 400 if one considers that average dipstick glucose of 2+ translates into a glucose concentration of around 10 mmol/L. C...

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Relevance Of Ds DNA Positivity With Negative Ana And Normal C3/c4 2 days ago

65 female Bg: CCF, Cellulitis, Hypothyroid , Obesity , Anxiety , IDA Admitted with urosepsis , right eye anterior uveitis , oral thrush and low...

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RE: Hyponatremia 2 days ago

So, average SIADH exacerbated by polydipsia. If this is not NSAIA related (Im very skeptical on that, "everybody" takes NSAIAs) If you have ...

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RE: Hypokalaemia 2 days ago

Could I offer another possibility...surreptitious use of diuretics? I find it unusual that a RTA would associate with a non-low (and perhaps mild...

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RE: Hyponatremia 2 days ago

Thank you for all your replys. Her serum uric acid is 4.6 mg/dl. renal function is reduced with eGFR of 55 ml/min, was attributed to RAASi and ...

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RE: Hypokalaemia 3 days ago

Excellent - thanks all. ------------------------------ Dr Adam Rumjon MBBS MRCP London ------------------------------

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RE: Hypokalaemia 3 days ago

Urinary K wasting and glycosuria with a nl serum glucose, proximal tubular disease (partial fanconi) I have seen this with HIV drugs , specifi...

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RE: Hyponatremia 3 days ago

" The U Na of 120 (120 x 2 = 240) does not allow for U K or other U osmoles suggesting the actual U osm should be much higher than 240." Good po...

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RE: Hyponatremia 3 days ago

serum osmolality 265 urine osmolality 240 urine Na 120 Is suspicious for a chronic SIADH with the concentrated urine. The U Na of 120 (120 x ...

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RE: Hypokalaemia 3 days ago

…the units of the UACR are mg/mmoL. --------------------------------- Dr Adam Rumjon MBBS MRCP London ---------------------------------

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RE: Hypokalaemia 3 days ago

Thank you very much. The phosphate level was within the normal range, 1 mmol/L. Thank you - yes I should send a urinary RBP and B2M. -----------...

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RE: Hypokalaemia 3 days ago

Looks like possible proximal tubule dysfunction (? Lamuvidine). Can you obtain a urinary Beta2 microglobulin or retinol binding globulin in the uri...

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Hypokalaemia 3 days ago

I was wondering whether I might be able to pick your collective brains. I can't quite work out why this woman has a low potassium... She was refe...

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RE: Hyponatremia 3 days ago

What is the serum urea. . The urine findings suggest low urea excretion, maybe Hyponatremia is due to low solute (urea) excretion. , but tge excess...

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RE: Hyponatremia 3 days ago

Case studies have been reported showing association between NSAIDS and hyponatremia. -According to UpToDate: Hyponatremia — NSAIDs diminish the ...

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RE: Hyponatremia 3 days ago

NSAIDs and hyponatremia ( euvolemic hyponatremia ) has rarely been reported. Usually Ibuprofen. what was uric acid? What was NsAID ? https://d...

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Hyponatremia 3 days ago

55 year old lady with background of hypertension on Coveram and metoprolol, had recent total knee replacement surgery and maintained on NSAIDs, pre...

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RE: Gross hematuria in a pregnant patient 3 days ago

Thanks, Dr. Alhosaini. ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 ------------------------------

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RE: Hypokalemia and hyperparathyroidism 3 days ago

Thank you all for your thoughts. I will do genetic study for Bartters and Gitelmans syndrome ------------------------------ Wael Jebur MD, FA...

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RE: Gross hematuria in a pregnant patient 3 days ago

My understanding from article 2 is that electrophoresis showed high beta globulin in all samples with different degrees of urine osmolality, this i...

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RE: Nephrotic range proteinuria associated with cGVHD Wednesday, March 12 @ 6:32 PM

As Dr. Rodby stated, FSGS is not common in SCT patients. This seems to me like a secondary FSGS with the normal Salb and glomerulomegaly. Is he obe...

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RE: IF negative anti-GBM Wednesday, March 12 @ 11:45 AM

Thanks Dr. Fogo. I agree that PLA2R + MN with superimposed crescentic GN due to aGBM and ANCA is a consideration. The totally negative IgG and the ...

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RE: Gross hematuria in a pregnant patient Wednesday, March 12 @ 10:58 AM

@Mohamad Alhosaini: Regarding the use of UAlb/Cr, UPr/Cr and urine protein electrophoresis to differentiate non-glomerular from glomerular bleeding...

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RE: IF negative anti-GBM Wednesday, March 12 @ 10:03 AM

Anti-GBM antibody disease and membranous nephropathy can coexist -it is thought that one injury can unmasked cryptic epitopes and play a part in tr...

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RE: IF negative anti-GBM Wednesday, March 12 @ 9:30 AM

"She was started on haemodialysis due to oligoanuria within days of presentation and remains dialysis dependent although improving urine output." ...

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RE: IF negative anti-GBM Wednesday, March 12 @ 4:29 AM

Thank you. The antiGBM has been repeated multiple times and after PLEX - the lowest has been 500 (there are two tests pending). They are runnin...

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RE: Nephrotic range proteinuria associated with cGVHD Wednesday, March 12 @ 3:38 AM

Dr.Venkat's suggestion is a very good one. If the patient has been on a CNI for a long time to suppress GVHD, then a secondary form of FSGS due to ...

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RE: Gross hematuria in a pregnant patient Wednesday, March 12 @ 3:36 AM

Thank you Dr. Venkat, very nice articles, of note the urine electrophoresis showed spike in beta globulin fraction and the albumin seemed to be oka...

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RE: IF negative anti-GBM Tuesday, March 11 @ 10:28 PM

Too bad no EM. False negative IF for IgG very uncommon in anti-GBM disease. . Something is very fishy about this case. What assay was used for anti...

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RE: Nephrotic range proteinuria associated with cGVHD Tuesday, March 11 @ 10:16 PM

Was cyclosporine or tacrolimus used post-stem cell transplant/GVHD? If yes, for how long? Besides GVHD itself, chronic CNI-related afferent arterio...

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RE: IF negative anti-GBM Tuesday, March 11 @ 9:18 PM

. ------------------------------ Victoria Sasongko MBBS FRACP Nephrologist Lismore Base Hospital Lismore, NSW Australia -------------------------...

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RE: IF negative anti-GBM Tuesday, March 11 @ 7:44 PM

What does 2+ 'membranous granular " mean? Can you post the de-identified pathology report.? ------------------------------ Richard Glassock MD, F...

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RE: Nephrotic range proteinuria associated with cGVHD Tuesday, March 11 @ 7:38 PM

Any Family History of kidney disease. I think I might do genetic testing. Any features by IF that suggest anti-nephrin auto-antibody. If so, I migh...

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RE: Nephrotic range proteinuria associated with cGVHD Tuesday, March 11 @ 7:12 PM

Thank you for your answer. This is not TMA or MGN. I believe it is FSGS. eGFR by Cistatin C is 40 mL/min. uProt. is in the 3 g/day range. pro...

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RE: Gross hematuria in a pregnant patient Tuesday, March 11 @ 5:37 PM

@K.K. Venkat Thank you ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ------------------------------

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IF negative anti-GBM Tuesday, March 11 @ 5:14 PM

Hi everyone, Presenting a case of a 65yo F, background AF, diabetes, bronchiectasis and hypothyroidism presented with RPGN (Cr normal > 500umol/L...

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