RE: CD19, ritux, and membranous 40 minutes ago

@Sheldon Hirsch "Roger, with that sort of thinking in mind...I have a patient who is now four months p the initial ritux rx, with an unchanged PL...

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RE: CD19, ritux, and membranous 1 hour ago

If your patient without any change in anti-PLA2R antibody 4 months after an initial dose of RTX was found not to be peripherally depleted in CD19 B...

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RE: CD19, ritux, and membranous 1 hour ago

Roger, with that sort of thinking in mind...I have a patient who is now four months p the initial ritux rx, with an unchanged PLA2r. I sent a CD19,...

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RE: PLA2R negative Membranous Nephropathy- Management Q 2 hours ago

Dr. Kaur - thanks for the follow up. The fact that this patient enters into a CR with RTX therapy places herin a favorable prognostic category - ab...

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RE: Resistant hypertension 3 hours ago

Thank you so much Dr. Rodby, Dr. Glassock, Dr. Dastoor for the opinion. ------------------------------ Jaison George MD, MBBS Kollam, India ----...

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RE: PLA2R negative Membranous Nephropathy- Management Q 5 hours ago

Hello All, This patient from a few years ago responds to rituximab that I am not giving on a consistent maintenance basis, since her proteinuria...

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RE: CD19, ritux, and membranous 18 hours ago

@Christian Kuhn writes "CD19 is usually monitored after rituximab because the drug (ritux/obi) occupies the CD20 epitope and can also induce CD20...

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RE: Persistant metabolic acidosis after cystectomy 20 hours ago

Recent information --------------------------------- Conjeevaram Kesavan MD, MBBS, FASN Duluth GA (678) 699-8521 ------------------------------...

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RE: CD19, ritux, and membranous 20 hours ago

As far as I am able to determine, no information exists concerning a possible interactions between Rituximab and Eculizumab, Ravulizumab , Iptacopa...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 20 hours ago

Please let us know what the final diagnosis is in fascinating canine case of the mysterious kidney ultrasound -nematodes, cancer , infection , calc...

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RE: CD19, ritux, and membranous 1 day ago

Thank you. As the immune response is quite specific, I wonder if the internalization of the FcR which follows Ritux therapy is unique to CLL cells ...

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RE: CD19, ritux, and membranous 1 day ago

There you go ------------------------------ Christian Kuhn MD Kantonsspital St. Gallen St. Gallen ------------------------------ Files At...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 2 days ago

Great plan, Eva! I have seen a few cases where the bladder urine is sterile, but the urine in the obstructed kidney shows bacteria. It's one of the...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 2 days ago

Thank you Mark, JD, and others who have responded! Agreed that the left and right kidney appear to have very different pathologies. For the lef...

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RE: Painless macroscopic hematuria 2 days ago

If other more likely causes for painless gross hematuria are excluded then even if NCS is diagnosed but no anemia or symptomatic varicocele , treat...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 2 days ago

Makes sense - could also do retrograde study rt kidney and stent if obstructed , biopsy left kidney after CT. I would still recommend KUB to help e...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 2 days ago

A CT can be done with sedation, but most frequently we do them under general anesthesia. The radiologists at my hospital certainly prefer GA when c...

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RE: CD19, ritux, and membranous 2 days ago

@Christian Kuhn Regrettably the DOI of the reference you posted appears to be incorrect. Could you please either revise it or attach the actual P...

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RE: Painless macroscopic hematuria 2 days ago

Painless gross hematuria for 2+ years- Nutcracker Syndrome unlikely but probably should be exclude with appropriate imaging studies if hemoglobin e...

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RE: Painless macroscopic hematuria 2 days ago

Although IgAN is most common disease in this age group, i would like to rule out other causes like Alport syndrome or Thin basement disease . On ...

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RE: CD19, ritux, and membranous 2 days ago

@Hormaz Dastoor II completely agree that CD20 internalization is primarily an issue with rituximab and occurs to a much lesser extent with obinutuz...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 2 days ago

Does a CT in a dog require general anesthesia? ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medic...

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RE: Persistant metabolic acidosis after cystectomy 2 days ago

Today only I reviewed the case presentation and hence delayed response I pulled out lot of information from resources Please pardon me for the le...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 2 days ago

What would NSAIDs be responsible here? Would love the veterinarians on this post to explain how this canine could possibly have normal renal functi...

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RE: CD19, ritux, and membranous 2 days ago

I think the "bottom line" is that we are still learning how to interpret CD19/20 B cell monitoring in peripheral blood in patients receiving anti-C...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 2 days ago

Hi Eva! Very weird left kidney for sure! I am worried the RK is obstructed from the nephrolith(s), potentially pyonephrosis. I'd be worried ab...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 2 days ago

It looks like this dog is headed for surgery to obtain a definite diagnosis-, nematodes, cancer, or nephrolithiasis or some combination of these.. ...

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RE: CD19, ritux, and membranous 2 days ago

@Christian Kuhn correct me if I am wrong but CD20 internalization is something specific to Rituximab only and not Second generation Anti CD20 agent...

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RE: CD19, ritux, and membranous 3 days ago

Dr. Kuhn- I agree that many long-lived Plasma Cells secreting potentially pathogenic auto-antibodies (CD19+ and CD20 - ) are not depleted by RTX ...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 3 days ago

Thanks for sharing -US iMO shows different process in left and rt kidney. The hematuria could be resulting from both but different pathologies. Nep...

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RE: Persistant metabolic acidosis after cystectomy 3 days ago

Thanks! My question is whether a bicarbonate of 20 mmol/L on Nephrotrans alone justifies surgical revision. The KDIGO 2024 CKD guideline gives [M...

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RE: CD19, ritux, and membranous 3 days ago

"CD20 + : expressed only on B cells and not on plasma cells . hence when anti CD20 agents such as rituximab are used , they deplete B cells directl...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 3 days ago

Copied and pasted your post on Google AI. It responded as follows: "The left kidney findings are highly concerning for a Renal Pelvic Diverticulu...

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Dog with hematuria and highly unusual renal ultrasonographic findings 3 days ago

Hello! I'm hoping for ideas on what we're seeing on ultrasound in a canine patient. The dog is an 8-year-old female spayed Cocker Spaniel who prese...

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RE: CD19, ritux, and membranous 3 days ago

I think, as you pointed out, that the interaction between Ritux and anti-complement agents is, for now, hypothetical. Aside from the occasional use...

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RE: CD19, ritux, and membranous 3 days ago

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

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RE: Persistant metabolic acidosis after cystectomy 3 days ago

I asked copilot what is the optimal length for ileal conduit. It came back with 20 cm. I think the urine pH confirms that the transit time is too l...

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RE: C3GN with lambda light chains Friday, July 10 @ 12:13 PM

@Richard Glassock thank you for that summary on K and Lamda chains . i was completely unaware of these succinct points highlighted . ------------...

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RE: CD19, ritux, and membranous Friday, July 10 @ 12:04 PM

Here is the link to the pictographs https://kdigo.org/wp-content/uploads/2026/06/KDIGO-2026-B-Cell-Conference-Report.pdf ---------------...

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RE: CD19, ritux, and membranous Friday, July 10 @ 10:04 AM

Dr. Rubin- Great point about the potential for an interaction between RTX and C inhibitors. This combination is seldom used ( except maybe in ANCA ...

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RE: CD19, ritux, and membranous Friday, July 10 @ 9:20 AM

@Hormaz Dastoor Great and succinct review of the key immunological issues involved. One important aspect to also consider is that Ritux requires ...

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RE: Painless macroscopic hematuria Friday, July 10 @ 9:00 AM

Thank you all for your suggestions and sharing your experience. I have requested a copy of the cysto report, I was going by the 'normal cysto' t...

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RE: C3GN with lambda light chains Friday, July 10 @ 6:45 AM

Dr. Dastoor - thanks for this nice summary. I have a few minor corrections Free lambda LC often spontaneously form dimers by covalent linkage ...

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RE: C3GN with lambda light chains Friday, July 10 @ 4:47 AM

Light chains ( usually lamda) can activate either the Classic Pathway or the Alternate Pathway (AP) Within the realm of Alternate Pathway : Lamd...

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RE: CD19, ritux, and membranous Friday, July 10 @ 2:42 AM

Yes, but this effect is seen mainly in lymphoid germinal centers, not in peripheral blood B cell pools. ------------------------------ Richard Gl...

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RE: CD19, ritux, and membranous Friday, July 10 @ 1:07 AM

Thanks so much Does obi deplete plasma blast more than rituxan ? --------------------------------- Muhammad Soobadar MBChB UK -----------------...

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RE: CD19, ritux, and membranous Thursday, July 9 @ 11:01 PM

CD19+ : expressed on B cells , Plasmablasts, Short lived Plasma cells ( CD19 +) and not expressed on Long Lived Plasma cells which are located in B...

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RE: Resistant hypertension Thursday, July 9 @ 10:31 PM

The drug has been approved in the UAE for uncontrolled HTN or resistant hypertension ( defined as 3 or more drugs). Hence these patients need not b...

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RE: CD19, ritux, and membranous Thursday, July 9 @ 10:22 PM

Dr. Hirsch-thsnks for the question. RTX is quite effective in depleting CD19/20+ B cells from peripheral blood but it is much less effective for de...

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RE: To RITUX or NOT RITUX Thursday, July 9 @ 10:16 PM

We had an MDT meeting with rheumatologist and GI team yesterday. We agreed to prophylactic Rituximab given his high risk and stop Avacopan. He seem...

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