RE: Nephrotic syndrome with massive bilateral PE 20 minutes ago

The comparative data of VTE in nephrotic syndrome is small and retrospective and most on primary prophylaxis rather than secondary prevention of li...

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RE: Nephrotic syndrome with massive bilateral PE 4 hours ago

Do DOAC work as well (efficacy) as Warfarin ,in preventing a recurrence of a life-threatening VTE in a morbidly obese patient with presumably treat...

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RE: Nephrotic syndrome with massive bilateral PE 8 hours ago

not to be picky but "Warfarin here, wouldn't trust NOAC) " DOAC may be safer in ACUTE PE unless CKD( CREAT CL < 30ML/MIN ), LIVER DZ, APLS, prostat...

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RE: MPO VASCULITIS 8 hours ago

Gastroentrelogist . Thanks Dr Glassock I looked at the literature and I could not find any association. ------------------------------ Dwa...

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RE: MPO VASCULITIS 9 hours ago

Where did the suggestion of "paraneoplastic association of elevated anti-MPO antibodies" come from. The anti-MPO antibody is most likely an associa...

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RE: Anti-gap positive metabolic acidosis 9 hours ago

was this the venous BG taken when AG WAS 18 or later ? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medi...

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RE: MPO VASCULITIS 11 hours ago

Thanks Drs Glassock and Dr Rodby. Alpha fetoprotein is not elevated. Started on empirical therapy despite a suggestion whether raised MPO tite...

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RE: Sclerosing peritonitis 12 hours ago

Thank you, Dr Rodby and Dr Bargman. This was the same pt I had presented a few months back. He has FSGS and lost his first transplant within a mo...

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RE: Sclerosing peritonitis 12 hours ago

I agree with you. Any kind of surgical intervention would be fraught and unlikely to turn out well. Hopefully it will settle down over time. The ba...

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RE: Anti-gap positive metabolic acidosis 12 hours ago

Obtained venous pH which was 7.35. Accompanying electrolytes had a serum HCO3 of 20 for an anion gap of 13. A repeat urinanalysis was also done wit...

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RE: Tuberous sclerosis in 34 year old 13 hours ago

According to my AI colleague,Claude - there are no firm data showing that mTOR inhibition is of value to reduced Kidney Cyst burden (as compared to...

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RE: Nephrotic syndrome with massive bilateral PE 13 hours ago

This issue of maximizing the speed of Remissions of NS by manipulating the use of drug combination for initial therapy is one common to MCD and MN....

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RE: Nephrotic syndrome with massive bilateral PE 14 hours ago

I doubt the CNI expedites anything except lowering of proteinuria until Rituximab kicks in. may decrease morbidity. ----------------------------...

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RE: Tuberous sclerosis in 34 year old 14 hours ago

She has significant CKD for TS and just some cysts which I suspect are more than being mentioned given the eGFR. Mtor inhibitors are great for a...

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RE: Nephrotic syndrome with massive bilateral PE 14 hours ago

Nice response Dr. Rodby- thanks for all of the References. I guess that CNI + RTX combois reasonable but I know of no study showing that the additi...

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RE: Sclerosing peritonitis 14 hours ago

EPS at age 17, that is just terrible. How long had the patient been on PD? You said it was spontaneous, bet there was an abscess. My limited ...

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Sclerosing peritonitis 15 hours ago

Dear all, This is a follow-up question for a 17-year-old patient whom I have inherited, who has sclerosing encapsulating peritonitis. I was getti...

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Tuberous sclerosis in 34 year old 16 hours ago

Hello everyone, 34-year-old healthy female came to clinic for evaluation of elevated creatinine of 2.0. Creatinine of 1.06 in 2022,no labs prese...

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RE: nephrotic syndrome with 18 hours ago

Has a bone marrow been done to evaluate IgM kappa and IgM lambda monoclonal bands Rheumatoid factor Cryoglobulins? -------------------------...

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RE: MPO VASCULITIS 18 hours ago

I suspect this patient could be treated without a kidney biopsy. But I would wonder If HCC is diagnosed that what would be the treatment? If this p...

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RE: Nephrotic syndrome with massive bilateral PE 18 hours ago

I have attached several articles on ritxumab as a first line therapy for steroid responsive NS THe response is variable but I think Dr Glassock'...

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RE: Nephrotic syndrome with massive bilateral PE 23 hours ago

Agree with Dr. Glassock that steroids are not my first choice due to morbid obesity and possible steroids AEs she may have. Proteinuria reduction ...

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RE: MPO VASCULITIS 1 day ago

No hydralazine therapy is reassuring. With platelets of 100,000 ,off Apixaban and normal INR a kidney biopsy would likely be reasonably safe. unusu...

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RE: Nephrotic syndrome with massive bilateral PE 1 day ago

The average time to CR for RatX monotherapy of MCD is about 25 days, and can be as short as 12 days. I am not sure that Prednisone is any quicker a...

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RE: Nephrotic syndrome with massive bilateral PE 1 day ago

There is really no evidence on triple therapy. I'm just adding Tac to limit steroids exposure, and this is as a bridge to rituximab until it takes ...

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RE: Nephrotic syndrome with massive bilateral PE 1 day ago

Thanks Dr Glassock. So you would just give Rituximab alone? Are steroids contraindicated during acute PE? I mean do they have prothrombotic ef...

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RE: MPO VASCULITIS 1 day ago

Thanks Dr Glassock. Platelets: 101000 101 L x 10^9/L Hb 8g/dl; INR 1.3 , Urine: No red cell casts or acanthocytes, HBV, HCV: Non-reacti...

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RE: ig a case is it alcohol/liver disease related. 1 day ago

This might be IgA Vasculitis complicating chonic alcoholic liver disease explaining the biopsy findings and the abdominal pain. (Visceralvasculitis...

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RE: nephrotic syndrome with 1 day ago

What is seum albumin, C3 and C4, HCV and HBV status.? Is he receiving anticoagulants. Prostatic cancer will not be a contraindication to chemothera...

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RE: MPO VASCULITIS 1 day ago

What is the level of platelets. What are his current medications? Does the urine show. RBC casts or acanthocytes. Vwhat is his HBV and HCV status a...

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RE: Nephrotic syndrome with massive bilateral PE 1 day ago

I do not think that a rebiopsy is indicated in the setting. She needs continual anticoagulation with full dose warfarin monitored carefully by freq...

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MPO VASCULITIS 1 day ago

Dear all 74 year old cacusian with the following comorbidities Hypertension Cirrhosis liver biopsy proven Jan 2025. No ascites no oesophag...

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nephrotic syndrome with 1 day ago

BG 76 male DIAGNOSES:  Left atrial appendage occlusion January 2024 (22mm Amulet device)  Permanent atrial fibrillation  Previous haemorrh...

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ig a case is it alcohol/liver disease related. 1 day ago

46Y M- GP referral with worsening abdominal pain and cramps PmHx; COPD CLD ETOH access IVDU Opioid type drug dependence - under turning p...

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RE: Nephrotic syndrome with massive bilateral PE 1 day ago

Is there added benefit of using pulse methyl pred compared to oral pred in DP? --------------------------------- Muhammad Soobadar MBChB UK ---...

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RE: Nephrotic syndrome with massive bilateral PE 1 day ago

I guess you are not planning to do kidney biopsy in this setting due to need to omit therapeutic anticoagulation in context of new life threatening...

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Nephrotic syndrome with massive bilateral PE 1 day ago

Dear colleagues, I would appreciate your input on this 16 year old morbidly obese (wt 127kg) female patient with hx of childhood onset nephrotic ...

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RE: IgA nephropathy in the setting of psoriasis/psoriatic arthritis 1 day ago

Prof Glassock’s recommendations dated 9/6/26 seems most appropriate, meaningful, logical and excellent holding psoriasis MAB agents and addressing ...

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RE: Anti-gap positive metabolic acidosis 2 days ago

Have you questioned the? mother regarding over the counter preparations containing Methyl Salicylate (oil of wintergreen) ? ---------------------...

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RE: Latent TB and Membranous Nephropathy 2 days ago

With CKD stage 4 the use of enoxaparin or warfarin are very tricky. This is a judgement decision that can only be made by the treating physician af...

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RE: IgA nephropathy in the setting of psoriasis/psoriatic arthritis 2 days ago

Good points Dr. Kesavan, but still would be more comfortable with stopping the Sekakinumab while steroids are being are being given for IgAN. Just ...

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RE: IgA nephropathy in the setting of psoriasis/psoriatic arthritis 2 days ago

Thank you Drs. Glassock, Rodby and Kesavan for your thoughts. These are all very helpful. There was no renal work up in April 2025. The initial ren...

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RE: Latent TB and Membranous Nephropathy 2 days ago

Thanks prof glassock hepatitis b /c negative Appreciate help Patient on treatment dose enoxparin with peak And trough level monitoring Have asked...

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RE: IgA nephropathy in the setting of psoriasis/psoriatic arthritis 2 days ago

Was any renal work up including biopsy done in April 2025 when he had worsening renal function and on set of UACR 1600 mg per gm creatinine -----...

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RE: Anti-gap positive metabolic acidosis 2 days ago

@Michael Emmett any thoughts ? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Panc...

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RE: IgA nephropathy in the setting of psoriasis/psoriatic arthritis 2 days ago

Dr. Rodby' points are all well taken. I would agree that supportive care should consist of an ACEi or an ARB plus an Endothelin antagonist (Atrasen...

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RE: Anti-gap positive metabolic acidosis 2 days ago

Sorry, I wasn't clear about the Tylenol. The mother only gives Tylenol and not aspirin, but he has not had any Tylenol for several months. Sent fro...

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RE: IgA nephropathy in the setting of psoriasis/psoriatic arthritis 2 days ago

Primary or secondary I'm not sure really matters at this point. This degree of ckd portends a bad long term renal prognosis. There is nothing wrong...

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RE: IgA nephropathy in the setting of psoriasis/psoriatic arthritis 2 days ago

This case illustrates the aphoristic situation of "being between a rock and a hard place" The IgAN is most likely an association with Psoriasis , b...

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RE: Anti-gap positive metabolic acidosis 2 days ago

Since pt got Tylenol it could have brought out an inherited glutathione deficiency? 5-oxoproline toxicity (also known as pyroglutamic acidosi...

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