RE: A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 13 minutes ago

Dear Dr. Garrick, Dr. Thomas, and Dr. Guevara-Pineda, Thank you for these insightful considerations and your help to solve the case. The patient ...

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RE: Lupus Nephritis 3 hours ago

the million dollar question actually 2 questions 1) Do you continue maintenance therapy "forever" 2) Do you treat abnormal serology alone (ot...

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RE: Severe COVID in Renal Transplant Patient - Tocilizumab? 3 hours ago

Tocilizumab is not very effective and may be harmful in organ transplant patients with severe COVID (see Pereira MR, et al Am J Transplant 2022; 20...

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Severe COVID in Renal Transplant Patient - Tocilizumab? 4 hours ago

Hello to all, We have a colleague of ours, 61 yo M, with HTN, ADPKD, s/p deceased donor kidney transplant 3 years ago, hospitalized 4 days ago wi...

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RE: Anti GBM with Fibrillary GN 4 hours ago

Thank you. MPO/PR3 negative. --------------------------------- Narothama Reddy Aeddula MD, FASN Newburgh IN (774) 641-1444 -------------------...

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RE: A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 5 hours ago

This condition seems to be a multi-systemic disease . Although viral infections can trigger severe inflammation ,tend to be self limited . Allow me...

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RE: A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 5 hours ago

Hi Fascinating case. A few questions Did he received treatment for his IGA nephropathy, and if so, what did he receive?Could that possibly be ...

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RE: ANCA vasculitis with AIN 5 hours ago

PR-3 and MPO antibodies received today and negative. I will not give rituximab and have discontinued steroid. Serum creatinine remains stable at 3....

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RE: A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 5 hours ago

Good day. What are his chronic medications? Would you entertain TB or viral infections other than Parvovirus 19, such as HIV or CMV? PNH can pres...

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Lupus Nephritis 5 hours ago

Looking for advice regarding a 41-year-old patient with SLE with lupus anticoagulant. She had kidney biopsy in January of 2017, which showed LN I...

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RE: A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 9 hours ago

Dear Dr. Venkat, Dear Dr. Glassock, Thank you for your valuable insights. Parvovirus B19 PCR is negative, making active infection unlikely. The...

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RE: Anti GBM with Fibrillary GN 13 hours ago

This assay has a false positive rate as high as 16% due to cross reactivity to other GBM auto-antigens -but this is a very high titer. Was the anti...

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RE: Anti GBM with Fibrillary GN 16 hours ago

Thank you Dr Glossock, Anti GBM levels were 263. IgG by multiplex bead. ARUP labs. --------------------------------- Narothama Reddy Aeddula MD...

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RE: Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 23 hours ago

I agree with most of the comments made. A biopsy would give a more definitive diagnosis, though I am not convinced that it is necessary. What is hi...

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RE: A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 1 day ago

Sorry-i meant hepatic vein , not portal vein, thrombosis. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-888...

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RE: A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 1 day ago

I also agree with Dr. Venkat that the clinical findings are compatible (including marrow aplasia, reactive arthritis and portal vein thrombosis) wi...

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RE: A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 1 day ago

What is the patients Mean corpuscular volume and peripheral blood smear, red cell morphology , and Hemoglobin electrophoreses? Could this be IgAN, ...

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RE: A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 1 day ago

Isolated ineffective erythropoiesis: Have you done blood parvovirus B-19 PCR (IgM and IgG antibodies less reliable)? Parvovirus can cause liver dam...

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A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 1 day ago

Distinguished colleagues, we seek your insight on a 38-year-old man whose clinical trajectory has recently changed in a way that we are strugglin...

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RE: Anti GBM with Fibrillary GN 1 day ago

Oral cyclophosphamide (CYC) + RTX combinations have been used to treat FGN. IV CYC is usually not used to treat Anti-GBM disease . What assay was u...

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RE: Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 1 day ago

I agree with Dr. Venkat. Clinically, this is most likely steroid-induced Osteoporosis, post kidney transplant. But a bone biopsy may be the only wa...

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RE: Anti GBM with Fibrillary GN 1 day ago

Yes. Active UA, since 07/2025. Pt was never referred to a nephrologist before. Walked into ER this past Monday with abnormal eGFR and UA follow...

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RE: Anti GBM with Fibrillary GN 1 day ago

There are rare reports of anti-GBM-ab RPGN and fibrillary GN occurring together: https://pmc.ncbi.nlm.nih.gov/articles/PMC4720204/ Wonder if anti...

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RE: Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 1 day ago

Pth 30 2020 now 100 --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 1 day ago

B alkaline phosphate not done. --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 1 day ago

Thanks prof venkat Alp= alkaline phosphate Kind regards --------------------------------- Muhammad Soobadar MBChB UK -------------------------...

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RE: Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 1 day ago

Kidney transplant 31 years ago, on prednisolone and cyclosporine since then. Both these drugs can cause osteoporosis. Intermittently high normal se...

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RE: Follow up 1 day ago

Dr. Whittier thanks so much -as I stated in my previous post one of my issues when we started letting IR do the biopsies even transplant, kidney bi...

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Anti GBM with Fibrillary GN 1 day ago

Hello all, Have an interesting case and appreciate your input. 57 year old Caucasian female with hx of rheumatoid arthritis, admitted on 3/16/20...

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RE: Follow up 1 day ago

yes, when we do the PRB, we typically do the right kidney. our protocol has been nephrology does the majority of the biopsies, but if they need CT ...

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RE: Follow up 1 day ago

Dr. Whittier- thanks so much for your input- does that mean that when you and your Colleagues, and therefore your fellows under their supervision, ...

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RE: ANCA vasculitis with AIN 1 day ago

creat gone up ------------------------------ Muhammad Soobadar MBChB UK ------------------------------

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RE: ANCA vasculitis with AIN 1 day ago

many thanks there is one artery that shows vasculitis . Creatinine has gone down rapidly. RF +ve, normal complement Blood culture negative I ...

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RE: Follow up 1 day ago

My practice plan is as follows: 1. Refer all outpatient biopsies to the university. High volume center, lower complication rate. 2. Due to the incr...

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RE: Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 1 day ago

adjusted calcium 2.20-2.60 mmol/l phosphate range mmol/l PTH ( 1.5-7.6 ) pmol/l thanks for input ------------------------------ Muhammad...

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RE: Follow up 1 day ago

Thank you for your valuable input. ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ------------------------------

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Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 1 day ago

Dear colleagues appreciate input on mx of bone disease and osteoporosis in renal tx recipient Cadaveric Tx Recipient 1995 Maintained on Neoral...

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RE: Follow up 1 day ago

There are several issues regarding definitions of major complications of percutaneous renal biopsy (PRB). One of them is that they are defined by n...

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RE: Lithium Nephropathy 1 day ago

I have had a number of cases of Lithium toxicity as well as testified in medical legal caes. The initial problem of toxicity is handled as you all ...

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RE: Follow up 2 days ago

Dr. Grimm thank you so very much for correcting my post on open evidence AI regarding complication rates between native kidneys. I also went back a...

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RE: Follow up 2 days ago

@Paul Grimm There is something strange about some of the findings of the study you referred to: 1.It found a greater risk of major complications ...

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RE: Lithium Nephropathy 2 days ago

The patient has substantial differences in size between the two kidneys. This is unusual in lithium induced nephropathy. think of additional path...

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RE: ANCA vasculitis with AIN 2 days ago

Dr. Glassock: Since SCr has plateaued at 3.7 mg for 3 days and the biopsy does not show any necrosis or crescents in glomeruli, I would follow-up t...

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RE: ANCA vasculitis with AIN 2 days ago

I would start steroids , and wait for the PR3 and MPO before starting Rituximab . --------------------------------- Dr. Hormaz Dastoor. MD, MSc, ...

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RE: ANCA vasculitis with AIN 2 days ago

Dr. Dastoor- would you treat this patient with Steroifs and RTX now based on the information available? ------------------------------ Richard Gl...

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RE: ANCA vasculitis with AIN 2 days ago

Is c- Anca positive with infections , or is it more likely to be a positive p- Anca with infections, drugs etc ?? -------------------------------...

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RE: Lithium Nephropathy 2 days ago

Dr Tirolien: Reviewed your Pt's case history. I have another idea (not disregarding the tole of Ch Lithium nephropathy in the slightest). I realize...

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RE: Follow up 2 days ago

Hi. This underscores why you must check original references when using AI. Dr. Lerman's AI report interpreted the reference exactly wrong. I fo...

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RE: ANCA vasculitis with AIN 2 days ago

Dr. Venkat. Endocapillary hypercellularity and mesangial expansion present . I am not sure the IF can be interpreted and no EM done. If the anti-MP...

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RE: ANCA vasculitis with AIN 3 days ago

Dr. Venkat, there is no EM attempted on paraffin sections . ------------------------------ Pongstorn Pitiranggon MD Pee Dee Nephrology Florence S...

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