RE: Severe Hypomagnesemia 6 hours ago

Thank you for all the useful comments. Bicarbonate initially was 31 when he also had low K but, with amiloride use both K and Bicarbonate remain no...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 8 hours ago

@Hormaz Dastoor-thanks for your comments several points spironolactone >100mg/day may not be tolerated in men epleronone is an option if nece...

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RE: Obstructing Urinary Stone 8 hours ago

The serum creatinine returned to her usual normal level (0.84mg/dL), approximately one week (or sooner) after laser fragmentation and removal of an...

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RE: Timing of blood sampling in twice-weekly hemodialysis regimens 10 hours ago

Luis: I am not sure whether any data exists as to what is a good time to take the blood samples. Proponents of incremental hemodialysis (like Dr Ka...

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RE: Severe Hypomagnesemia 13 hours ago

Other ideas or expansions of ones already suggested: (1) Other better tolerated Mg salts [citrate, aspartate, glycinate, gluconate, lactate (see NE...

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RE: recurrent intracerebral hemorrhagic stroke in a young female known case of hypertension VS ANCA associated vasculitis 13 hours ago

TThank you, Dr. Mohammed. She has had multiple brain imaging studies, including CT angiography with stroke protocol, MRI, and MR venography. I...

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RE: recurrent intracerebral hemorrhagic stroke in a young female known case of hypertension VS ANCA associated vasculitis 14 hours ago

Thanks for case 2023 icb with high bp active urine sediment Was mpo negative then +ve after introduction of hydralazine I am interested to know ...

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RE: another ANCA case 14 hours ago

With 500 mg Rituximab , did you check for CD19 depletion. Also did the c- anca ever become negative during therapy or not ?? Guess in refractory ...

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RE: Severe Hypomagnesemia 14 hours ago

Magnesium citrate if available has better absorption than the oxide Have u tried sglt2i.. --------------------------------- Dr. Hormaz Dastoor. ...

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RE: another ANCA case 16 hours ago

Thank you, Dr. Glassock. ------------------------------ Amit Joshi Chicago IL ------------------------------

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 16 hours ago

(@Mark Lerman) I do not think eprelonone is a strong anti HTN, and I would prefer to use Spironolactone or even Baxdrostat here . Since he has gai...

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RE: Severe Hypomagnesemia 16 hours ago

@Bijan Roshan Can try Mag-Tab SR in epic. --------------------------------- Mohammad Atari, M.D. Assistant Professor of Medicine University of Mi...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 16 hours ago

Could this be secondary hyperaoldosteronism due to obesity? https://pmc.ncbi.nlm.nih.gov/articles/PMC2904339/ https://pmc.ncbi.nlm.nih.gov/arti...

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RE: MPGN with IgM, C1q, kappa and lambda, no Immune Complexes 16 hours ago

Thank you Dr.@Lynn Cornell --------------------------------- Mohammad Atari, M.D. Assistant Professor of Medicine University of Mississippi Medica...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 17 hours ago

I suspect it is primary aldo as well. ------------------------------ John Mellas MD Nephrology and Hypertension Specialists St Louis MO 314537235...

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RE: Biopsy or not to Biopsy 19 hours ago

I would not have done too. Not sure I would know what I was looking for 🥺 That’s why we have prof glassock to make us better doctors and thinkers...

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RE: Alveolar haemorrhage in ANCA vasculitis 20 hours ago

Thanks prof glassock for help Any comments anti gbm (rpgn) and ph without hypoxemia - would you olex? (I would ) Found an interesting article ht...

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RE: Biopsy or not to Biopsy 20 hours ago

None of the above , but will do, was busy clinic ... that's my excuse !! --------------------------------- Dr. Hormaz Dastoor. MD, MSc, FASN Divi...

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Timing of blood sampling in twice-weekly hemodialysis regimens 23 hours ago

It is becoming increasingly common to initiate hemodialysis with a twice-weekly schedule as part of an incremental hemodialysis approach. I am wond...

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RE: MPGN with IgM, C1q, kappa and lambda, no Immune Complexes 1 day ago

It's always hard to interpret someone else's immunofluorescence report. If there are no immune type deposits on EM, then I would favour a TMA proce...

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RE: Alveolar haemorrhage in ANCA vasculitis 1 day ago

PLEX has a very limited role in ANCA Vasculitis with pulmonary involvement in absence of anti-GBM disease. I personally do not recommend its use in...

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RE: another ANCA case 1 day ago

Relapsing anti-PR3 ANCA Vasculitis is fairly typical, especially with interruption of regular maintenance dosing of RTX. Avacopan has no real benef...

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another ANCA case 1 day ago

Hello, I came across the following case from friend who reached out to me for a family member. 75 yo F with HTN and osteoporosis 10/2023 Lef...

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RE: Alveolar haemorrhage in ANCA vasculitis 1 day ago

Beat --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Alveolar haemorrhage in ANCA vasculitis 1 day ago

Thanks for update pet scan when steroids at reduced dose Any sensory deficit ? Ncs /emg could be helpful Cardiac mri seems reasonable I would inv...

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RE: recurrent intracerebral hemorrhagic stroke in a young female known case of hypertension VS ANCA associated vasculitis 1 day ago

Thank you, Prof. Lerman. In 2023, at the age of 37, during her first event, her blood pressure was recorded at 200/100-110. However, it was su...

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RE: Severe Hypomagnesemia 1 day ago

Sorry if I missed was serum bicarbonate elevated? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical D...

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RE: Severe Hypomagnesemia 1 day ago

That's good to know. I just looked and they have many lactate forms, including SR.

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RE: Severe Hypomagnesemia 1 day ago

Magnesium lactate is available on Amazon. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine a...

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RE: Severe Hypomagnesemia 1 day ago

Sorry-I misinterpreted your post. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine at UCLA L...

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RE: Severe Hypomagnesemia 1 day ago

Sorry, I meant no OTC, No herbal supplement and no other meds X 2,000 IU daily Vitamin D3. ------------------------------ Bijan Roshan MD, FASN S...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

IMO -has criteria for PA -SALINE suppression with low serum k is not valid- response to spironolactone is very suggestive of PA. with normal k, imp...

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RE: Severe Hypomagnesemia 1 day ago

What herbal supplement is he taking? ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine at UCL...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

The PRA and aldosterone levels cannot be interpreted while he is on the medicatiions you describe, but the clinical picture Strongly suggests Prima...

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RE: Biopsy or not to Biopsy 1 day ago

Have you carefully examined his skin for angiokeratomas (buttocks and scrotum especially ) ? Does he have acroparasthesias ? Any absence of perspir...

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RE: Lipid Management In Young Patient With Steroid Responsive Do 1 day ago

As of now, there is no firm evidence linking episodes of dyslipidemia accompanying steroid sensitive nephrotic syndrome with the later incidence of...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

Sorry the title should have read somewhat suppressible aldosterone --------------------------------- Edwin Anand, M.D. Nephrology Practice of Nia...

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RE: Biopsy or not to Biopsy 1 day ago

He does not have hypertension , and is not on any medications for proteinuria either . Except for the albuminuria all his labs are normal for now ...

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RE: Lipid Management In Young Patient With Steroid Responsive Do 1 day ago

If untreated with statin and no ace inhibitors Guess a registry study could answer this question for lets say miminal chsnge relapsers who arr st...

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RE: Lipid Management In Young Patient With Steroid Responsive Do 1 day ago

Thanks so much Will execute plan Can I ask this patient was yo have one relapse a year over next 2-3 years but let’s say rapid response to steroid...

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Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

A 44 yr old white male with a hx of HTN for about 5 yrs was admitted to the hospital with severe HTN with a palpitatoins, BP was 230/130 on present...

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RE: Severe Hypomagnesemia 1 day ago

No PPI. No other meds, etc, supplement, herbal x 2000 iubvitamin d by us for borderline levels. Normal PTH.

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RE: Severe Hypomagnesemia 1 day ago

PPIs? (even though this is urinary wasn't) history of amoinoglycosides? CNIs? Ampho? ------------------------------ Roger Rodby MD, FASN...

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RE: Severe Hypomagnesemia 1 day ago

No alcohol intake ( I even checked PETH test for him). Both RA and asthma in remission. Was on extended realese 15 mg daily upadacitinib (Rinvoq) a...

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RE: Severe Hypomagnesemia 1 day ago

How much alcohol does he consume per week? What are the current medications are used to treat asthma and RA? ------------------------------ Richa...

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Severe Hypomagnesemia 1 day ago

I have this patient: 30 YO gentleman with History of Rheumatoid Arthritis, Asthma, anxiety who was admitted with to hospital after routine labs sho...

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RE: IgA nephropathy in a 28 yo 1 day ago

The rationale for "aggressive" therapy is well stated by Dr. Rodby- but do we know that anti-April or anti-April/BAFF is better than MMF + systemic...

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RE: Alveolar haemorrhage in ANCA vasculitis 1 day ago

Just to update all Bronchoscopy was not suggestive of pulmonary haemorrhage. Echocardiogram show severely impaired LV systolic function. BNP ele...

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RE: Simple question - EDEMA 1 day ago

The extended duration of spironolactone can avoid some of the rebound Na retention, but I would still not use it , if possible . No easy cure for t...

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RE: Biopsy or not to Biopsy 1 day ago

4th opinion, you should flattered, until he gets a fifth opinion and then your ego can take a hit. well this does not appear to be tubular prote...

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