RE: Advanced IgA Nephropathy 1 hour ago

Thank you Dr Glassock, that's a great point. Ethan Orlev, MD FACP

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RE: Diffuse Lymphoid infiltrate on native kidney biopsy w/o lymphoproliferative disorder. 3 hours ago

We recently saw a 77 y o lady with CLL, CKD III due to DM and HTN that developed AKI and became anuric requiring dialysis. The kidney biopsy can be...

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RE: Advanced IgA Nephropathy 9 hours ago

I doubt that Sparsentan would result in harm, but the prospects for meaningful clinical benefit are low and uncertain. If BP became easier to contr...

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RE: Advanced IgA Nephropathy 12 hours ago

Hi Dr Hirsch Thank you for your reply! I agree with you. The patient unfortunately is not very compliant. Would you even consider the Sparsentan ?...

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RE: Advanced IgA Nephropathy 13 hours ago

If you can get his BP under control his GFR will almost certainly decrease, esp if the ARB is increased, maybe even to 15 or less, depending on how...

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RE: Advanced IgA Nephropathy 13 hours ago

With a GFR this low and severe IFTA it is unlikely that any therapy will greatly alter the high likelihood of further progression to ESKD. The tria...

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Advanced IgA Nephropathy 14 hours ago

Hi My pt is 38 y/o M who was diagnosed with IgA Nephropathy on 3/2024 pt had a hematuria episode as a child that was treated with steroids an...

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RE: Diffuse Lymphoid infiltrate on native kidney biopsy w/o lymphoproliferative disorder. 1 day ago

Biopsy was done for rapidly rising Cr and proteinuria worsening from around 1 g to 7 g in 6 months before biopsy was done. No h/o pyuria I agree ...

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RE: Diffuse Lymphoid infiltrate on native kidney biopsy w/o lymphoproliferative disorder. 1 day ago

PET/CT was negative. Oncologist has agreed to do BM biopsy ------------------------------ Asjad Sardar MD SOUTHWEST KIDNEY INSTITUTE Tucson AZ (6...

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RE: PIGN with only proteinuria? 2 days ago

I think we are all in agreement that glomerular sub-epithelial "hump-like" deposits are non-specific having been observed in APSGN, IRGN, C3GN, DDD...

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RE: PIGN with only proteinuria? 2 days ago

In Primary C3GN the "intensity" of C3 staining by conventional IF is required to be greater than the intensity of IgG , IgA or IgM. The serum C3 le...

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RE: Electrolyte Issue 2 days ago

Vegetable proteins have a net alkaline content, whereas meat protein has a net acid content, but both proteins stimulate acid (proton) secretion in...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 2 days ago

If you are interested serving as a reviewer, please complete this form by May 7: https://www.asn-online.org/apply/?ID=21 Questions? Send an email...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 2 days ago

Hi I am a fellow in Pediatric Nephrology. I am willing to volunteer to review case reports Thank you Afsana Jahan Get Outlook for iOS The informa...

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RE: PIGN with only proteinuria? 2 days ago

@ prof glassock ? C3 GN would the c3 be more intensity on IF? Or are there cases where c3 is equal intensity to others and it’s is c3gn? I unders...

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RE: Electrolyte Issue 2 days ago

Thanks everyone really enlightening . Questions lead to discovery . I apologies for not being clever but why does vegetarian meal give rise to high...

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RE: Electrolyte Issue 2 days ago

As a fellow at NYU long ago, my attending Bernie Nidus, showed us his clear, pre-prandial urine, followed by a post-prandial urine: completely opaq...

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RE: PIGN with only proteinuria? 2 days ago

Th IF is PLA2R, sorry the label didn't show up. ------------------------------ Jonathan Zuckerman MD, PhD UCLA Los Angeles CA (310) 794-1485 ---...

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RE: PIGN with only proteinuria? 2 days ago

I don't disagree that the deposits appear hump-like. Rare cases of early MN can show somewhat humpy deposits. Please see attached images from a cas...

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RE: PIGN with only proteinuria? 2 days ago

those are HUMPS! was there only C3 on the biopsy? What was the blood C3 level? See attached ------------------------------ Ro...

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RE: PIGN with only proteinuria? 2 days ago

While I agree the deposits could be seen as hump-like, given the membranous pattern noted above on IF, this may be an early (stage 1) membranous ne...

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RE: Electrolyte Issue 3 days ago

I remember being taught that the commonest cause of a urine sample with a high pH in clinical practice is a patient submitting a urine sample short...

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RE: IVIG with Rituximab treatment 3 days ago

I agree that the general felling (not evidence based) is that IVIgG is "helpful" in some cases of ANCA Vasculitis.- unfortunately we do not know wh...

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RE: IVIG with Rituximab treatment 3 days ago

Just one thought: while I agree that IVIG administration based on IgG level may be unwarranted, IVIG has been regarded as therapeutically helpful i...

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RE: Electrolyte Issue 3 days ago

Many thanks for the clarification. My understanding of the "alkaline tide" has just improved. I assume that patients with atrophic gastritis (and h...

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RE: Electrolyte Issue 3 days ago

Just a small point, but the term alkaline tide refers to the normalphysiologic response after any meal, due to the stimulation of parietal cell pro...

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RE: PIGN with only proteinuria? 3 days ago

Setting all STI biases aside, have you ruled out secondary syphilis? --------------------------------- Oded Friedman -----------------------------...

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RE: PIGN with only proteinuria? 3 days ago

Thanks for posting the EM. This does not seem to be APSGN or Infection related GN, so C3GN in the differential diagnosis. The pattern of C3 and C4 ...

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RE: PIGN with only proteinuria? 3 days ago

EM deposits certainly look "humpy". Very strange case. Clinical presentation certainly suggests MCD/FSGS/podocytopathy. Will be interesting to see ...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 3 days ago

Hello! If you are interested serving as a fellow case report reviewer, please complete this form by May 7: https://www.asn-online.org/apply/?ID=21 ...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 3 days ago

Hello! If you are interested serving as a reviewer, please complete this form by May 7: https://www.asn-online.org/apply/?ID=21 ----------------...

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RE: PIGN with only proteinuria? 3 days ago

attached is the EM. very curious. ------------------------------ Kenneth Brand MD West Hartford CT (860) 819-9001 ---------------------------...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 3 days ago

Hello, i would like to volunteer as a reviewer for case reports. Please let me know further steps. Best regards, Arjun -------------...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 3 days ago

I have done several case reports and here is my Google scholar page. I could be valuable resource for moderating case reports. https://schola...

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RE: Case discussion Thursday, April 17 @ 3:50 AM

Thanks alot for ur valuable comments Yahoo Mail: Search, Organize, Conquer

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RE: Case discussion Thursday, April 17 @ 3:03 AM

The main differential diagnoses are malaria (falciparum and/or vivax), G6PD deficiency and paroxysmal cold hemoglobinuria, in my Nephrological opin...

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RE: Case discussion Thursday, April 17 @ 2:27 AM

Thanks . What are other down the list differentials ?? Yahoo Mail: Search, Organize, Conquer

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RE: Atypical case Thursday, April 17 @ 2:14 AM

Linear monoclonal IgA deposits suggest anti-GBM Disease, but absence of crescents would be unusual. Serum anti-GBM antibodies by ELISA are often ne...

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RE: Case discussion Thursday, April 17 @ 1:49 AM

Based on this classic presentation , this patient should be strongly suspected as having PNH. The diagnosis can be quickly affirmed by appropriate ...

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Case discussion Thursday, April 17 @ 1:22 AM

17 years old male , hx of renal stones 8 years back, passed spontaneously in urine, no intervention required and no labs done at that timeNo other ...

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RE: Atypical case Wednesday, April 16 @ 9:25 PM

Updated the case as requested. ------------------------------ Hasan Ozpolat MD University of Arizona College of Medicine Tucson AZ (206) 393-785...

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RE: PIGN with only proteinuria? Wednesday, April 16 @ 8:25 PM

Infection related GN presenting as proteinuria only is uncommon. Could you post the de identified EM photos, so we can verify the nature of the "Hu...

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RE: Complex SLE Case with Diffuse Alveolar Hemorrhage Wednesday, April 16 @ 5:43 PM

For reasons that remain poorly understood , DAH us strongly related to anti.Phospholipid antibody . I would agree with adding RTX (or OBI , if avai...

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PIGN with only proteinuria? Wednesday, April 16 @ 5:14 PM

could turn out to be nothing special, but what i have here, folks is a 78-year-old white gentleman with sudden onset 8-10 grams of proteinuria an...

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RE: Atypical case Wednesday, April 16 @ 3:25 PM

IgA with lambda restriction is not usual and does not mean a MGRS, but that is lambda not kappa. Linear IgG is not unusual with Diabetes and is f...

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RE: Atypical case Wednesday, April 16 @ 3:02 PM

Didn’t see that coming. When will EM be available? What did pathologist conclude? LHCDD on background of DM/HTN changes? Did TBM also stain simi...

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RE: decline in kidney function linked with Graves disease Wednesday, April 16 @ 2:59 PM

Hi thanks fascinating . If the hypothesis of gfr drop causing hypothyroid would be interesting to know kidney function in hyperthyroid pre and post...

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RE: Complex SLE Case with Diffuse Alveolar Hemorrhage Wednesday, April 16 @ 2:53 PM

Thanks for the thoughtful feedback. Haptoglobin is very low, with C4 at 0.035 and C3 at 0.5 Regarding Ravulizumab, my thinking is that complement...

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Atypical case Wednesday, April 16 @ 1:14 PM

A 58-year-old female with a history of diabetes mellitus type 2 with retinopathy, uncontrolled hypertension, chronic lymphedema, and systemic lupus...

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RE: Complex SLE Case with Diffuse Alveolar Hemorrhage Wednesday, April 16 @ 12:53 PM

We had a somewhat similar patient last year, did not have alveolar hemorrhage but had a MAHA with thrombocytopenia, AKI, seizures We plexed h...

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