RE: Ext 1 poistive biopsy 14 minutes ago

All labs were negative for lupus. ------------------------------ Amal Ezzaiyani MD Prairieville LA 218927346618 ------------------------------

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RE: Ext 1 poistive biopsy 14 minutes ago

Appreciate your reponse! She has full-blown nephrotic syndrome. I will dicuss the Ritux with the family this week and go from there. Thanks, ...

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RE: a case of TMA 2 hours ago

Sara pardon My ignorance Please explain what r these antibodies anti-RP11, anti-RP155, anti-DFS70 Was Scl70 Ab,RNA Polymerase or fibrillarin (U3...

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RE: Plar2 +ve With Stroke 4 hours ago

In light of the additional information provided, I think I would do an anti-PLA2R antibody by IFA to exclude a possible false + ELISA. ----------...

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RE: Plar2 +ve With Stroke 6 hours ago

Additional info I can see that March 2025 was when he first made contact with liver team and had decompensated liver disease/Cirrhosis. Seems the...

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RE: a case of TMA 10 hours ago

Update on this patient: I have sent genetic testing for aHUS and it came positive for homozygous deletion of the entire CFHR1 and CFHR3 genes. Unfo...

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RE: Parathyroid mass with severe hypercalcemia 14 hours ago

Dr. Mighni: can you please provide another a further update regarding parathyroid pathology, and evolution of serum calcium, PTH and SCr levels? Di...

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RE: Plar2 +ve With Stroke 15 hours ago

Sounds like the kidney in on fire with this rapidly progressive MN perhaps plus other lesions so agree your concern Dr. Dastoor about over-immunosu...

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RE: Ext 1 poistive biopsy 16 hours ago

Around 30% of EXTI/II MN have no SLE defining features, but a young woman should be suspected of harboring a propensity to develop SLE. Not uncommo...

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RE: Ext 1 poistive biopsy 16 hours ago

Lupus ------------------------------ Alvaro Medina Resident Pontificia Universidad Catolica de Chile Santiago 935428727 -------------------------...

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RE: Ext 1 poistive biopsy 17 hours ago

Exostocin is most commonly associated with lupus and other autoimmune diseases, and while your patient does not have positive autoimmune serology, ...

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RE: Plar2 +ve With Stroke 20 hours ago

Looking at his case , his eGFR has declined over 12 months from 70 to 21 ml/min. Given his age have you ruled out a monoclonal disorder . Also h...

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Ext 1 poistive biopsy 1 day ago

Greetings, I am managing a 16-year-old female patient diagnosed with nephrotic syndrome. A kidney biopsy revealed membranous glomerulopathy with ...

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RE: C3 or IgA 1 day ago

Almost always - don't know why; I have seen so many patients with diverse main pathologic diagnosis - associated with some degree of IgA related ...

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RE: C3 or IgA 1 day ago

Dr Balan thanks for your post something very practical for private Nephrologist Have seen these CFHR protein mutation result often with genetic te...

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RE: pigment on biopsy cause? 1 day ago

Could be melanin or lipofuscin, and in either case a feature of Hermansky-Pudlak syndrome. Lipofuscin should be autofluorescent by UV fluorescence ...

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RE: Plar2 +ve With Stroke 2 days ago

A kidney biopsy is indicated due to the rapid decline in GFR, but this may not be possible with a recent CVA. And need for anti-coagulation . If hi...

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RE: pigment on biopsy cause? 2 days ago

The staining characteristics of the golden- brown pigment suggests lipofuschin granules. This would be indicative of the Hermansky-Pudlak Syndrome ...

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RE: Plar2 +ve With Stroke 2 days ago

Active urine sediment and rapid decline in renal function. Both these features are atypical in MN alone. Need to exclude renal vein thrombosis. ANC...

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RE: Plar2 +ve With Stroke 2 days ago

Definitely use a combination for rapid control on proteinuria CNI plus either CYC or Rituximab would be a good option. With higher levels of antiP...

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RE: Plar2 +ve With Stroke 2 days ago

Sounds like rapidly progressive disease with very high serum PLA2R Ab and possible thromboembolic phenomenon so I would use a combination of RTX an...

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Plar2 +ve With Stroke 2 days ago

71 male patient lives in out of area Clinic referral to nephrology new patient New diagnosis of liver cirrhosis likely MASLD around end of 24 , A...

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RE: possible SLE/CTD to biopsy or not. 2 days ago

Update : -haematology advice can do renal Biopsy with platelet of 100 above . - renal rheumatology mdt have decided for Kidney biopsy She also ...

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RE: Transplant Question 2 days ago

Thanks everyone and prof venkat I will Get it and post xmatch Bw --------------------------------- Muhammad Soobadar MBChB UK -----------------...

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pigment on biopsy cause? 2 days ago

Many thanks for referring this 20 year old man who was found to have a raised creatinine while he was in hospital in Kuwait with a dislocated shou...

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RE: C3 or IgA 2 days ago

FHR-1 and FHR-5 compete with CFH for C3b binding, reducing CFH’s regulatory effect and promoting complement-mediated injury. Elevated plasma level...

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RE: What are the biggest non-clinical hurdles to CCM adoption in Nephrology? 2 days ago

Hello Richard. Thanks for your response. We postulate that CCM provides the greatest, most measurable benefit for CKD patients who are at a high ri...

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RE: What are the biggest non-clinical hurdles to CCM adoption in Nephrology? 2 days ago

What categories of patients with CKD do you postulate CCM will directly lead to better outcomes ? What are the outcomes that can be directly measur...

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RE: C3 or IgA 2 days ago

My understanding is that CFHR proteins, in general inhibit the action of CFH. Deletions of CFHR genes, especially heterozygous deletions are quite ...

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What are the biggest non-clinical hurdles to CCM adoption in Nephrology? 2 days ago

Hello everyone, I'm a new member, and I'm interested in starting a discussion around Chronic Care Management (CCM), specifically for our patient ...

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RE: C3 or IgA 2 days ago

So something i learned in ASN. CFH is a regulatory protein of the Alternate complement pathway CFHR1-5 are also regulatory proteins , assisting C...

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RE: Kidney Xplant w new skin cancer: Best IS recipe 3 days ago

I too am not aware of nicotinamide use for SCC . Systemic retinoids, particularly oral acitretin has been used for SCC prevention, but has adverse ...

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RE: Kidney Xplant w new skin cancer: Best IS recipe 3 days ago

As far as I know, nicotinamide is not effective in prevention or therapy of squamous cell sjim cancer developing in an immunosuppressed transplant ...

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RE: C3G- What's Next 3 days ago

Many thanks. The "real life" experiences with a novel are very valuable to the practicing physician, who often is lacking in reference points due t...

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RE: C3G- What's Next 3 days ago

So, we have 8 patients in Pegcetacoplan and 1 on Iptacopan for C3G and IC- MPGN. While they all qualified for expensive treatments from their insu...

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RE: C3G- What's Next 3 days ago

I do not recall that we got the full biopsy report. The question is always what trigger or drive the disease. Did the patient have genetic testi...

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RE: Use Of Ace Inhibitor/Arab For A Single Kidney 3 days ago

You are so welcome Dr Safdar To add a great article from KI about management of patients with acquired single kidney. -----------------------...

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RE: Use Of Ace Inhibitor/Arab For A Single Kidney 3 days ago

Dr Aledan thanks very helpful Thanks for the reference --------------------------------- Shahzad Safdar MD Mt. Auburn Nephrology, Inc. Cincinn...

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RE: True hyponatremia and normal osmolality 3 days ago

I hate to enter into the fray and prolong this thread but I thought I would put in my two cents just to unify the comments of Drs. Asplin, Uribarri...

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RE: Use Of Ace Inhibitor/Arab For A Single Kidney 3 days ago

There is no strong evidence or guideline recommendation for prescribing ACE inhibitors (ACEi) or angiotensin receptor blockers (ARBs) solely to pre...

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Use Of Ace Inhibitor/Arab For A Single Kidney 3 days ago

Question for the panel. Have a patient donated kidney to his mother. Blood pressure 120/80. No Albuminuria or proteinuria. Does he need to be on Ac...

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RE: Transplant Question 3 days ago

Could you send a picture of the virtual cross match please ------------------------------ Daniel Guevara-Pineda MD West Hartford CT ------------...

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RE: Kidney Xplant w new skin cancer: Best IS recipe 3 days ago

While BCC is more common than SCC in the general population, reverse applies in the transplant population. Azathioprine is associated with increase...

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RE: Kidney Xplant w new skin cancer: Best IS recipe 3 days ago

Because the SCC associated with MMF in kidney transplant recipients are usually of a non-agressive histological type, I would favor a modest reduct...

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RE: Kidney Xplant w new skin cancer: Best IS recipe 3 days ago

Appreciate Dr Venkat comments and sharing the thread from 2017 which reviewd this topic. Turns out my patient has squamous cell skin cancer not B...

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RE: IV iron chelators 3 days ago

I am honored by your invitation and look forward to the opportunity to participate in this interesting discussion. In the early eighties, when I w...

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RE: membranous nephropathy and multiple myeloma Thursday, November 6 @ 12:18 AM

Thanks for the notions. I also thought that Daratumumab would be appropriate, and I will suggest it again to our hematologists. IgG subclass sta...

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RE: Transplant Question Wednesday, November 5 @ 7:46 PM

HLA-B locus homozygosity means that the donor inherited the same HLA-B antigen from both parents. In other words, donor's HLA-B locus paternal and ...

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RE: Transplant Question Wednesday, November 5 @ 6:33 PM

Thanks prof glassock Why is it b mm not 2 if homyzogous ? --------------------------------- Muhammad Soobadar MBChB UK -----------------------...

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RE: True hyponatremia and normal osmolality Wednesday, November 5 @ 2:53 PM

:(…not at ASN…yes, Sosm = total body osm/TBW so (I guess) if there was a gain of particles (made in RBCs), it would increase Sosm…but there’s also ...

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