RE: IgAN with unusual course 4 hours ago

I doubt that this is PGNMID (with monoclonal IgA), but I would probably request LC staining of Pronase digested Paraffin embedded slide., as if thi...

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RE: Page Kidney 6 hours ago

"Current case is a unilateral kidney with 7x7 cm subcapsualar hematoma likely arising from a cyst acute presentations with aki" I assume this mea...

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RE: Page Kidney 7 hours ago

Yes, you are dealing with a native single kidney which appears to have developed a rather sizable and complex peri-capsular collection which led to...

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IgAN with unusual course 7 hours ago

Dear all, Would love to hear your thoughts on this patient: 40 yr old Asian female with no PMH, recent large intake of ibuprofen for several weeks...

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RE: Page Kidney 7 hours ago

I get that, but then what are there so many reports of percutaneous drainage, ALSO if it bleeds you will know from drainage tube and they can go in...

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RE: Page Kidney 7 hours ago

in this case a native kidney. i agree i think that there is likely to be some resolution with drainage/unroofing. however, urology suggest that the...

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RE: Page Kidney 7 hours ago

I have seen several cases in kidney transplant cases following a biopsy. It's drainage is associated with rapid resolution of the AKI and the assoc...

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RE: Page Kidney 8 hours ago

I have NO experience with this but I know our IR folks would drain it in a heartbeat I googled percutaneous draining of sub capsular hematoma an...

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RE: What is the type of native kidney disease in this patient? 8 hours ago

Dr. Glassock: In this patient, MN has recurred in the kidney transplant without anti-GBM antibody or crescentic GN (at least till now). Doesn't thi...

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Page Kidney 9 hours ago

Curious if anyone out there has any experience with getting urology to evacuate and or do capsulotomy with page kidney and sub capsular hematoma Th...

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RE: CKD 4, Waldenstrom and Solitary Kidney 12 hours ago

What was SCr before nephrectomy. If already elevated, uni-nephrectomy might have caused hyperfiltration/secondary FSGS. SAlb level? Urine sediment?...

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RE: CKD 4, Waldenstrom and Solitary Kidney 12 hours ago

Challenging case. The possible explanation for this scenario are numerous: lymphocytoplasmic lymphoma (LPL) infiltration, hyperviscosity, intraglom...

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RE: What is the type of native kidney disease in this patient? 12 hours ago

Dr. Venkat, you have a good point about leaving well enough alone. The patient still have active disease in the allograft. The stability of crea...

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CKD 4, Waldenstrom and Solitary Kidney 15 hours ago

70 yo pt with hx of DM2, HTN, kidney cancer, status post Nephrectomy, Waldenstrom. Pt is noted slowly progressing CKD with creatinine about 2.5, a...

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RE: Treatment Resistant Primary FSGS 1 day ago

Dr. Germain. This thread has been very informative and brought much needed attention to High-dose IV CsA as an alternative to therapy of multi-drug...

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RE: What is the type of native kidney disease in this patient? 1 day ago

"At time of transplant biopsy: SCr 1.1 m/dL; SAlb 4.1 g/dL; UAlb/Cr 811 mg/g; UPr/Cr 1.0 g/g; anti-GBM antibody 0.9 IU [normal [More]

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RE: Treatment Resistant Primary FSGS 1 day ago

I agree with Dr Glassock that IV cyclo should be reserved for resistant cases. It may have a special place in immediate recurrence pot transplant. ...

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RE: Lupus nephritis in pregnant woman 1 day ago

That good to know that you have requested her record.

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RE: Urinary C5b9 1 day ago

To my knowledge this assay has not yet been "commercialized" so it is only available on a research basis, an cannot be reported into the medical ch...

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RE: Focal Necrotizing Immune Complex GN 1 day ago

It is not uncommon for ANCA+ and ANCA - SVV to show some Ig deposition . in glomeruli. See Haas M, et al Kidney Int. 2004; 65:2145-2152. Lack of EM...

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RE: What is the type of native kidney disease in this patient? 1 day ago

I would treat with SQ Velcade and Daratumumab. You can replace Daratumumab with Rituxan or other anti-CD20, but run the risk of lack of response. D...

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RE: Treatment Resistant Primary FSGS 1 day ago

"I think the evidence that CNI reduce the circulating levels of permeability factors in Primary or recurrent FSGS is virtually non-existent" I ap...

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RE: Focal Necrotizing Immune Complex GN 1 day ago

Thank you prof Glassock Any explanation for Immuncomplex deposition with ANCA negative vascilitis here --------------------------------- Mohame...

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Urinary C5b9 1 day ago

Does any one know of a core lab or facility who is doing urinary C5b9 assay? ------------------------------ Ashraf El-Meanawy , MD, MS, PHD, FASN...

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RE: Focal Necrotizing Immune Complex GN 1 day ago

The negative kappa and lambda stains are surprising in light of 2+ IgG and IgA. I do not think that this is Heavy chain Disease, but IgG subclass s...

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RE: Lupus nephritis in pregnant woman 1 day ago

Thank Dr. Rodger. I will definitely start aspirin. ------------------------------ Pongstorn Pitiranggon MD Pee Dee Nephrology Florence SC (843) 6...

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RE: Lupus nephritis in pregnant woman 1 day ago

This patient has recently relocated to our area, and the medical records have been requested. ------------------------------ Pongstorn Pitirangg...

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RE: Lupus nephritis in pregnant woman 1 day ago

Medical records are a fundamental part of a doctor's duties in providing patient care. As well as handwritten clinical notes, medical records inclu...

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RE: Focal Necrotizing Immune Complex GN 1 day ago

Patient a febrile , blood c/s negative ECHo aortic sclerosis no vegetation Cryo negative RF negative Hep B,C,HIV Negative T spot blood Negative...

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RE: Focal Necrotizing Immune Complex GN 1 day ago

on the biopsy report there are neutrophils, make sure that the patient does not have SBE. RF may help, or cryos with low C3 (although C4 often V...

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RE: Focal Necrotizing Immune Complex GN 1 day ago

I have update to pathology report This glomeruli with crescent showed focal segmental necrosis (not mentioned before) 17 glomeruli GLOMERULI: O...

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RE: Lupus nephritis in pregnant woman 1 day ago

at 14 weeks you have a LONG way to go, good luck to her. She is hardly "out of the woods" ASA for Preeclampsia prophylaxis is a good idea for su...

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RE: Blood transfusion in potential kidney transplant candidate 1 day ago

Presuming all values for iron indices are in Scientific units, converting to to US Units, the serum iron is 162 mg/dL, the ferritin 1880 mg/dL, and...

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RE: Blood transfusion in potential kidney transplant candidate 1 day ago

Hi Dr Besarab, Her Hb was 60g/L Her last iron studies = Fe 29 ; TSat 68 ; Ferritin 837 ; Transferrin 1.7 Her current EPO is darbepoetin 150mc...

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RE: Lupus nephritis in pregnant woman 1 day ago

Thank you all for your recommendations. Her current BP is 131/80, albumin 2.3, Hgb 6.9 ->8.1 after 1 unit of PRBC transfusion, Platelet 68K. Lupu...

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RE: Focal Necrotizing Immune Complex GN 1 day ago

Thank you anti- MPO and anti-PR3 ANCA was by ELISA --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH KUWAIT 00965 513777...

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RE: Lupus nephritis in pregnant woman 1 day ago

Current BP, anti-ds-DNA antibodies, and anti-phospholipid antibodies? I agree with Dr. Glassock that kidney biopsy is not required at present and a...

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RE: Lupus nephritis in pregnant woman 2 days ago

I like dr Glassock's answer. This is bad lupus and these drugs are safer than the outcome for mother and baby if not treated. ------------------...

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RE: Lupus nephritis in pregnant woman 2 days ago

I would use high dose steroids, Tacrolimus and possibly AZAthioprine. I don't think that a kidney biopsy . is absolutely necessary in this case. Wh...

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RE: Treatment Resistant Primary FSGS 2 days ago

I agree 100% that a CNI (usually oral ) should be used in preference to CYC in Steroid resistant Primary FSGS with persisting NS, but I have my dou...

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Lupus nephritis in pregnant woman 2 days ago

27 y/o CA female G1P0 in 14 week gestation with previous lupus nephritis diagnosed by kidney biopsy 2019 ( no medical records for review at present...

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RE: Treatment Resistant Primary FSGS 2 days ago

Thanks for this input. As shown by the TANGO registry, use of High-dose IV Cyclosporin to therapy of recurrent Primary FSGS is largely restricted t...

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RE: Focal Necrotizing Immune Complex GN 2 days ago

Yes, I believe so. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

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RE: Focal Necrotizing Immune Complex GN 2 days ago

Thank you for valid input, Patient is not on hydralazine Lambda is not mentioned in IC pathology report. I don’t know if it is available. No arth...

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RE: What is the type of native kidney disease in this patient? 2 days ago

pdf of Dt Glasocks Commentary is attached ------------------------------ Anatole Besarab MD ABesarab Consulting Bend OR (734) 417-4793 ---------...

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RE: What is the type of native kidney disease in this patient? 2 days ago

The correct reference is Glassock RJ. Membranous Nephropathy due to anti-GBM antibodies : of mice and men. Am J Nephrol. 2020;51:96-98. It is avail...

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RE: Treatment Resistant Primary FSGS 2 days ago

Poor results with PLEX in recurrent Primary FSGS in kidney allografts can often be traced to delayed initiation of therapy- Good results (> 50% rem...

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RE: Treatment Resistant Primary FSGS 2 days ago

The reference from 2019 in Pediatric Nephrology deals only with children and steroid responsive MCD- the experience with CNI in adults with steroid...

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RE: Focal Necrotizing Immune Complex GN 2 days ago

Is the patient on hydralazine. I agree with Dr.Venkat - you need ELISA anti- MPO and anti-PR3 to exclude ANCA + crescentic GN. What were the LC sta...

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RE: Treatment Resistant Primary FSGS 2 days ago

I want to emphasize that CNI RX should not be considered to be failed therapy until you push the dose and the levels to the point where you feel th...

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