RE: Hypocalcemia And Hypoparathyroidism 4 hours ago

Thanks Dr Glassock Regyanti-Cytokine antibodies characteristic of auto- immune poly-glandular syndrome Type 1 (Il-22 ,etc) I did not I thought t...

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RE: ADPKD ON JYNARQUE 4 hours ago

Thanks Dr Glassock I think KDIGO still did not recommend --------------------------------- Shahzad Safdar MD Mt. Auburn Nephrology, Inc. Cincin...

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RE: IgA Kappa PGMID and EGPA 9 hours ago

This thread reminds me of the difficulty in unequivocally establishing monoclonality of Ig depidits.using frozen IF and anti-Kappa and Anti-Lambda ...

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RE: ADPKD ON JYNARQUE 10 hours ago

A recent crossover study from Japan showed benefit on eGFR-Creat-CystC in patients with ADPKD already treated with high dose Tolvaptan.( See Uchiya...

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RE: Hypocalcemia And Hypoparathyroidism 10 hours ago

Very interesting case. Dis you examine the profile of anti-Cytokine antibodies characteristic of auto- immune poly-glandular syndrome Type 1 (Il-22...

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Hypocalcemia And Hypoparathyroidism 11 hours ago

49-year-old female with history of partial colectomy 2006 due to diverticulitis 18 inches of colon removed possible sero negative Rheumatoid arthri...

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RE: Autosomal dominant Tubulointerstitial Kidney Disease 12 hours ago

Do canadian patients are eligible If yes I will enroll two patients --------------------------------- Bajinder Reen MD Etobicoke ON (905) 453-0...

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ADPKD ON JYNARQUE 12 hours ago

I have a patient who is 43 years of age with ADPKD with creatinine 2 GFR 42. Proteiniris 254 mg is there any role for SGL2 inhibitor with his condi...

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RE: Autosomal dominant Tubulointerstitial Kidney Disease 14 hours ago

I also have a quite newly discovered patient with HNF-beta1 mutation. Do you also include such patient into your registry? I have referred the pati...

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RE: IgA Kappa PGMID and EGPA 14 hours ago

I arrived at a 16-gage needle because unless there was significant loss of glomerular density (Fibrosis) ,one good pass was all that was needed. I ...

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RE: IgA Kappa PGMID and EGPA 15 hours ago

That's a good questions. There is also the issue of over submission to IF and EM at the expense of LM even when the biopsy is adequate. --------...

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RE: IgA Kappa PGMID and EGPA 15 hours ago

I will also add that radiologist here at UCLA are also excellent (with on-site adequacy). They use 18 g and we rarely have inadequate specimens. Th...

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RE: IgA Kappa PGMID and EGPA 15 hours ago

I do not think there is fixed choice. Institution choice affect. In our group we use 18g which has internal diameter of 0.838 mm (say 0.8). The 16g...

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RE: IgA Kappa PGMID and EGPA 15 hours ago

I believe that your statement, "And I am sure in some situations each pass is just dropped into each fixative vial without any though" may be all t...

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RE: Unknown left pleural effusion 16 hours ago

The catheter appears to be inserted in the left subclavian or even the lt brachiocephalic vein (and not the right IJ). This is very likely catheter...

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RE: IgA Kappa PGMID and EGPA 18 hours ago

I by trial and error determined that the 16 g needle was the proper choice when the automatic "guns " were introduced. I have no idea what gauge is...

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Multi-center Study - Kidney Transplant for Oxalate Nephropathy 19 hours ago

Hello, I am a kidney transplant surgeon at the University of Minnesota. We are looking to put together a multi-center retrospective study of pat...

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RE: IgA Kappa PGMID and EGPA 19 hours ago

This is center dependent. Ideally there is on-site adequacy at the beside where a pathologist, technician, or other personnel from pathology (or ra...

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RE: IgA Kappa PGMID and EGPA 19 hours ago

Based on my reading of the literature and recommendations I have heard from others is that 16g needle is the recommended gauge to balance safety an...

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RE: IgA Kappa PGMID and EGPA 1 day ago

thank you for the references. I loved the Vims Silverman needle because the cores were larger and a good pass gave an adequate core that was enough...

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RE: IgA Kappa PGMID and EGPA 1 day ago

I agree that reduction in the inner diameter of the biopsy may contribute to the relative inadequacy of Bx tissue. I have been out of clinical medi...

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RE: ? Cryoglobulinemic GN 1 day ago

Doesn't look like fibrillary or immunotactoid or any other named organized deposition process to me. ------------------------------ Jonathan Zuc...

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RE: ? Cryoglobulinemic GN 1 day ago

Agree that there is some vague organization to the deposits that doesn't seem to resolve as microtubules at high mag. I would also suggest cryo be ...

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RE: IgA Kappa PGMID and EGPA 1 day ago

Here is an interesting study regarding on-site adequacy effect which demonstrated improved diagnostic material and an interesting study from Arkana...

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RE: IgA Kappa PGMID and EGPA 1 day ago

Science and Health Care should have no borders. Welcome to an organization dedicated to improving both world-wide. ------------------------------...

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RE: IgA Kappa PGMID and EGPA 1 day ago

Welcome to Canada. Glad to have you on our side --------------------------------- Bajinder Reen MD Etobicoke ON (905) 453-0821 -----------------...

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RE: Autosomal dominant Tubulointerstitial Kidney Disease 1 day ago

Dr Bleyer thanks a lot I have 37-year-old single gentleman with HNF1B Gene: HNF1B, Kidney-Associated Disease(s): HNF1B-Related Disor-ders, Inheri...

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RE: IgA Kappa PGMID and EGPA 1 day ago

I remember carrying my Medical School Microscope to assess the adequacy of the Bx specimen. I hated to get a repot stating "medulla only". The diss...

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RE: Unknown left pleural effusion 1 day ago

forgot to attach articles this seems to be not rare but I have never seen it, The literature totally supports venous blockage as the cause of ...

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RE: Unknown left pleural effusion 1 day ago

This seems to be related to a central venous stenosis according to the several articles I am attaching, in each case they removed the catheter and ...

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RE: Autosomal dominant Tubulointerstitial Kidney Disease 1 day ago

the good thing is it is never too late! we are always available to help with this. Thanks! Tony ------------------------------ Anthony Bleye...

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RE: IgA Kappa PGMID and EGPA 1 day ago

I agree with Dr. Zuckerman on all his points! In the past, we had the additional tool of the "Hevylite" antibody staining for IgA-kappa and IgA-l...

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Unknown left pleural effusion 1 day ago

A 58-year-old ESKD female on HD via a right internal jugular tunneled catheter, in february 2025 a native AVF brachiocephalic was performed, with p...

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RE: Autosomal dominant Tubulointerstitial Kidney Disease 1 day ago

@Anthony Bleyer This is a big deal thanks. I did not know that Natera Renasite, our go to gene panel was not able to make a MUC-1 diagnosis. ...

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RE: ? Cryoglobulinemic GN 1 day ago

These EM deposits seem organized to me, not obvious microtubules but not typical "bland" electron dense deposits either. @Jonathan Zuckerman @L...

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RE: IgA Kappa PGMID and EGPA 1 day ago

there is lot of data on IR doing renal biopsies but I dont think there is data on adequacy based on if they look at the specimen or not. Let me t...

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RE: IgA Kappa PGMID and EGPA 1 day ago

So much has changes then. We gave away kidney BX to the radiologists. I wonder what their success is ? How many passes, how many glomeruli and what...

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RE: ? Cryoglobulinemic GN 1 day ago

Thanks. Electron micrographs are attached. ------------------------------ Mustafa Ahmad MD, FASN Consultant Nephrologist King Fa...

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Autosomal dominant Tubulointerstitial Kidney Disease 1 day ago

Hi Colleagues: Just to alert you on some recent updates about autosomal dominant tubulointerstitial kidney disease: 1) Characteristics: Autosomal...

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RE: IgA Kappa PGMID and EGPA 2 days ago

KM55 has been shown to be negative in a small # of IgA-PGNMID cases but again data here are very limited but if positive would push me towards an u...

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RE: IgA Kappa PGMID and EGPA 2 days ago

No worries :) ------------------------------ Jonathan Zuckerman MD, PhD UCLA Los Angeles CA (310) 794-1485 ------------------------------

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RE: IgA Kappa PGMID and EGPA 2 days ago

I retired from patient care in 2017. I do only voluntary teaching of fellows now. Even 8 years ago, biopsy of both native and transplant kidneys wa...

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RE: IgA Kappa PGMID and EGPA 2 days ago

Correction It should read DrZuckerma Apologies for the mistake --------------------------------- Bajinder Reen MD Etobicoke ON (905) 453-0821 ...

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RE: IgA Kappa PGMID and EGPA 2 days ago

That was our experience , particularly when Fellows made the passes., They tended to i deeper and ger more medulla and we would have a few glomerul...

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RE: IgA Kappa PGMID and EGPA 2 days ago

Would KM55 staining help in this situation DrZuckman? --------------------------------- Bajinder Reen MD Etobicoke ON (905) 453-0821 -----------...

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RE: IgA Kappa PGMID and EGPA 2 days ago

Thanks Dr. Zuckerman for your very cogent, sage and helpful comments. One wonders if this is really an "atypical IgAN " whether RTX is a good choic...

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RE: IgA Kappa PGMID and EGPA 2 days ago

Pronase IF may be helpful to confirm kappa LC predominance; although given the trace-1+ lambda staining in the first biopsy, I would be careful abo...

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RE: IgA Kappa PGMID and EGPA 2 days ago

If plenty of glomeruli are available in the Paraffin embedded blocks, I would not do a repeat biopsy just to get additional frozen material.. do wh...

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RE: IgA Kappa PGMID and EGPA 2 days ago

With respect to preservation of fertility. She is from Algeria and delivered a live child while on therapy for IgA PGNMID then developed Churg-Stra...

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RE: IgA Kappa PGMID and EGPA 2 days ago

Thanks .i understand the limitations posed by scarce frozen tissue. But Pronase can be dine on Paraffin embedded tissue You are looking to unmask l...

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