RE: Renal transplant with pan resistant Kelbsiella colonization 9 hours ago

Please see attachment Important to know the Hx surrounding the R nephrectomy. Do the low CC of 10 X 3 represent a balance between the or...

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RE: Renal transplant with pan resistant Kelbsiella colonization 9 hours ago

Please see the attachment ------------------------------ Anatole Besarab MD ABesarab Consulting Scottsdale AZ (734) 417-4793 -------------------...

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RE: Is this Immune complex GN or something else? 10 hours ago

Yes Dr. Besarab. He is currently just on Prednisone 60 mg daily which was started 3 weeks ago pending results of the biopsy. I will be seeing him i...

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RE: Is this Immune complex GN or something else? 10 hours ago

Thank you very much Dr. Zuckerman for your detailed review and expert assessment. As suggested before by Dr. Rodby as well, I have requested for th...

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RE: Is this Immune complex GN or something else? 10 hours ago

Thanks Dr. Zuckerman for your very detailed interpretation, based on the written report only ( without a direct review of the slides and photos) I ...

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RE: Is this Immune complex GN or something else? 11 hours ago

Images would be helpful. From reading the biopsy description above, a few observations accepting the descriptive text as is: As Dr. Glassock note...

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RE: Renal transplant with pan resistant Kelbsiella colonization 12 hours ago

What about tigecycline and colistin? With so few organisms, I wonder if therapy is indicated at all. What do ID consultants opine? -------------...

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RE: Renal transplant with pan resistant Kelbsiella colonization 12 hours ago

Like Dr Venkat I assume that bilateral Nephrectomy was done presumably for infection within a Cyst(s) and the risk from that . Any data on that? ...

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RE: Renal transplant with pan resistant Kelbsiella colonization 13 hours ago

It seems only right nephrectomy was performed. The source could be bladder or possibly left kidney. Patient is in New Delhi so Bacteriophage is li...

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RE: Renal transplant with pan resistant Kelbsiella colonization 13 hours ago

I assume "nephrectomy" refers bilateral native nephrectomy. This suggests bladder colonization. May discuss with urology with any antibiotic/chemic...

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RE: Renal transplant with pan resistant Kelbsiella colonization 18 hours ago

What about sensitivity to Colistin and Fosfomycin? Any experience from the community about bacteriophages in this situation? --------------------...

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RE: Rituximab for Minimal Change GN - For how long ? 20 hours ago

Concur that Genetic testing will not impact therapeutic decisions. Dr Buhary is in KSa where to my understanding some patients will have Genetic te...

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RE: Renal transplant with pan resistant Kelbsiella colonization 21 hours ago

What is the source of the specimen showing such colonization? Has the test been repeated at least once? ------------------------------ Richard Gl...

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Renal transplant with pan resistant Kelbsiella colonization 1 day ago

This is about an ESKD sec to PKD. He underwent nephrectomy a few months ago and has recurrent growth of Pan resistant (even Carbopenam) Klebsiella ...

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RE: Rituximab for Minimal Change GN - For how long ? 1 day ago

What genetic association have been shown in MCD? . Several candidate circulating factors and their effects on podocytes have been proposed but are ...

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RE: Rituximab for Minimal Change GN - For how long ? 1 day ago

Dr Buhary have you considered doing Genetic testing. ------------------------------ Awais Nauman HMC Doha ------------------------------

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RE: Is this Immune complex GN or something else? 1 day ago

So you favor 2 diseases rather than one. Per Dr Glasscock's interpretation previously, :"Dr, Hickam would be very pleased but Reverend Occam would ...

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RE: Is this Immune complex GN or something else? 1 day ago

"IgAN nephropathy (atypical) may present with MCD like picture and it's responded to steroids." MCD and IgAN may be two independent disorders wit...

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RE: Is this Immune complex GN or something else? 1 day ago

I see your poiint. Well taken. Theses studies have one potential drawback. Pronase digestion and paraffin IF were not performed So the possibility ...

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RE: Is this Immune complex GN or something else? 1 day ago

My reading of the study is that IgA dominant IRGN and IgA dominant MPGN were classified separately in the cited study. --------------------------...

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RE: IgA nephropathy 2 days ago

I do not understand the origin of your statement " that those (patients with IgaN) with clones in the intestines may be better served (with Tarpeyo...

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RE: IgA nephropathy 2 days ago

Looking from different angle: What the ethnicity of this patient, her birth weight, was she premature at birth, any maternal exposure (tobacco and ...

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RE: Immunotactoid GN treatment 2 days ago

Dr. Glassock thanks for your question. I am not aware of any trial of use of combination of RTX (or Obinutuzumab) plus Daratumumab for ITG. My advi...

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RE: Is this Immune complex GN or something else? 2 days ago

Agree that NSAIDs-induced MCD doesn’t occur after their discontinuation and the remission of MCD occurs after treatment discontinuation. IgAN neph...

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RE: Is this Immune complex GN or something else? 2 days ago

Although the localisation of immune deposits is quite odd.. I agree with the experts here that the picture fits the most with IgAN or IgAVN. Does h...

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RE: Immunotactoid GN treatment 2 days ago

Thanks to everyone who responded Regarding the chronic urticaria - she has it for almost 10 years now. But the idea of a possible CLL tying every...

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RE: Is this Immune complex GN or something else? 2 days ago

Where is the infection provoking a proposed IgA dominant IRGN? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388...

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RE: Is this Immune complex GN or something else? 2 days ago

KM55 staining might help in teasing out IgA vs IgA dominant MPGN KM55 staining in evaluation of IgA ------------------------------ Awais Nauman...

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RE: Is this Immune complex GN or something else? 2 days ago

I agree with your explanations. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -------------------------...

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RE: Is this Immune complex GN or something else? 2 days ago

This was one of my initial thoughts for this case. What doesn't fit is that he used NSAIDS 4 months ago for about a month and then stopped. NO NSAI...

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RE: Is this Immune complex GN or something else? 2 days ago

Thanks for your input. Patient has no clinical features of scleroderma, no evidence of microangiopathic hemolytic anemia (MAHA) on his labs and ren...

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RE: Immunotactoid GN treatment 2 days ago

Dr Aleday "As Daratumumab act on CD38 positive plasma cells and B cells and not on CD19 and CD20 memory B cells" doesnt this figure imply other...

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RE: Immunotactoid GN treatment 2 days ago

Interesting idea Dr. Aledan. Thanks . Do you know of any actual trial data describing the effects of combination of RTX + Daratumumab or Obinutuzum...

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RE: Is this Immune complex GN or something else? 2 days ago

Interesting suggestion Dr. Aledan. Two diseases rather than one. Dr, Hickam would be very pleased but Reverend Occam would not. How would you treat...

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RE: Is this Immune complex GN or something else? 2 days ago

I assume you rule out scleroderma renal crisis. NSAIDs may explain severe nephrotic syndrome and possible AIN (some intestinal inflammatory cells)...

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RE: Immunotactoid GN treatment 2 days ago

Or combination of Daratumumab and RTX or preferable off-label use of Obinutuzumab to target both hidden B and plasma cell clones. As Daratumumab ac...

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Applications for the ASN Kidney Week 2025 Travel Support Programs (Including Kidney STARS) Now Open! 2 days ago

Travel support applications for the world’s premier nephrology meeting, ASN Kidney Week, will close on Wednesday, June 18, 2025. Encourage your tra...

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Applications for the ASN Kidney Week 2025 Travel Support Programs (Including Kidney STARS) Now Open! 2 days ago

Travel support applications for the world’s premier nephrology meeting, ASN Kidney Week, will close on Wednesday, June 18, 2025. Encourage your tra...

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RE: Immunotactoid GN treatment 3 days ago

This case is a fairly classical example of a MGRS and Immunotactoid Glomerulopathy.(ITG) By definition, the deposits in PGNMID are non - organized....

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RE: Is this Immune complex GN or something else? 3 days ago

Yes. Sometimes we do get lucky to get a lot of glomeruli on the biopsy. We have an interventional radiologist who does the biopsies. There is alway...

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RE: Rituximab for Minimal Change GN - For how long ? 3 days ago

Found this article that focus on electrolyte and other compound transfer ------------------------------ Anatole Besarab MD ABesarab Consulti...

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RE: Rituximab for Minimal Change GN - For how long ? 3 days ago

As I understand the action of SGLT2 inhibition, the main effects are on the proximal tubule. Reabsorption of about 66% of sodium is accomplished in...

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RE: Immunotactoid GN treatment 3 days ago

Clone directed therapy is always the way to go if you have light chain restriction, but this reminds me of what is often seen in PGNMID, clear ligh...

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RE: Immunotactoid GN treatment 3 days ago

With MPGN pattern of injury and no clinically obvious cause, I would always look for hidden malignancy. Surprisingly, malignancy may even be diagno...

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RE: Alport syndrome 3 days ago

Dr Glassock makes an important point, amicar has not been used for glomerular bleeding but Jan 18: RBC 349/HP; ultrasound confirmed left...

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RE: Rituximab for Minimal Change GN - For how long ? 3 days ago

Would love to know if he has anti-nephrin Ab induced podocytopathy, and if so, does he show increasing circulating anti-nephrin Abs before relaps...

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RE: Rituximab for Minimal Change GN - For how long ? 3 days ago

Could you post the complete metabolic panel, so we can determine the anion gap, etc. With a EFR estimate only 25% od so below expected there should...

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RE: Rituximab for Minimal Change GN - For how long ? 3 days ago

Bicarb remains between 17-19 often ------------------------------ Dr Mohamed Buhary MBBS, FRCP, FASN Consultant Nephrologist Jeddah ----------...

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RE: Is this Immune complex GN or something else? 3 days ago

Usually the pathologist would tell us , not enough glomeruli in the biopsy sent. I am ompressed by > 50. How many passes did you make and do you ha...

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RE: Rituximab for Minimal Change GN - For how long ? 3 days ago

In my clinical practice, I am not use regular RTX therapy such as every 3-6 months but instead follow up patient every 3 months for the 1st year an...

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