RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 3 hours ago

Auto BMT was in March 2023. Sent from my iPhone

View Discussion

RE: Salmonella Sepsis and C3 GN???? 6 hours ago

Should gear to biopsy ( not hear) Thanks --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: Salmonella Sepsis and C3 GN???? 6 hours ago

Thanks prof glassock What about c4d/c1q - evidence of classical pathway activation ? Also in PSGN if no active infection how do you treat ? Is A...

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 6 hours ago

Thanks prof glassock This patient has AL in 2022 Not clear what date bone marrow transplant was done and would be helpful to know. Serum free ligh...

View Discussion

RE: Salmonella Sepsis and C3 GN???? 6 hours ago

IRGN is a generic term embracing all forms of infection related GN (bacteria, virus, fungi, Protozoa, helminths). Acute Post streptococcal GN (APSG...

View Discussion

RE: anti gbm/mpo +ve in young female 6 hours ago

This is a great forum to hear about interesting cases and learn from each other. Special thanks to Dr. Glassock and Dr. Rodby for sharing their exp...

View Discussion

RE: Salmonella Sepsis and C3 GN???? 6 hours ago

I guess the million dollar question will you send for complement factor and genetic studies if c4 remains low after 3 month ? ------------------...

View Discussion

RE: Salmonella Sepsis and C3 GN???? 6 hours ago

Have you checked cryo? Rf and hepatitis ? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: Salmonella Sepsis and C3 GN???? 6 hours ago

@ dr hormaz iRGN ( I suspect you mean infection related GN) PSGN -(post streptococcal GN) Can you explain why you think IRGN involves classical...

View Discussion

RE: anti gbm/mpo +ve in young female 7 hours ago

Thanks appreciate the sharing and learning from paediatric nephrology Kind regards --------------------------------- Muhammad Soobadar MBChB U...

View Discussion

RE: Fibrillary GN, unresponsive to rituximab 7 hours ago

Thanks Yes they don’t work on plasma cells or memory cells which in conditions like AL amyloid or IG a vasculitis with clone use of bortezomib or...

View Discussion

RE: Fibrillary GN, unresponsive to rituximab 7 hours ago

Both RTX and OBI are monoclonal antibodies against CD20 -they bind to and eliminate CD20+ /CD19+ B-cells but they do not eliminate CD20-/CD19+ B ce...

View Discussion

RE: Hypercalcemia in ESRD 7 hours ago

Thanks for case What was PTH, alkaline phosphate before hospitalisation ? Has he ever had bone biopsy ? If he has adynamic disease then giving b...

View Discussion

RE: anti gbm/mpo +ve in young female 8 hours ago

I do not think that I have done anything.I have had only 2 boys that I can recall who had SLE with renal involvement with DPGN. They were pre teens...

View Discussion

RE: Fibrillary GN, unresponsive to rituximab 8 hours ago

OBI and RTX are effective in CD20+/CD19 +B cell but would be ineffective in CD19+/CD20-B Cell mediated Disease @ prof glassock please explain ? ...

View Discussion

RE: Fibrillary GN, unresponsive to rituximab 8 hours ago

Thanks I guess need to look retrospectively at serum of fgn without obvious cause Look at serum levels of the heat shock protein and see post ri...

View Discussion

RE: Normocalcemic Hyperparathyroidism or Idiopathic Hypercalciuria 8 hours ago

Worsening BMD on serial measurements will be an important determinant of the need to consider PTX in this 39 year old patient> Dr. Sprague: Is tr...

View Discussion

RE: AKI - D 8 hours ago

Dr. Shakeel: Please ask the rehab center to obtain daily body weights and urine volumes. You can also have that center to draw blood biochemical pr...

View Discussion

RE: Fibrillary GN, unresponsive to rituximab 9 hours ago

I am not sure that Fibrillary GN is a clonal disorder (monotypism is rare). We do not know if CD19+ B Cells are crucial for FGN either. no trials w...

View Discussion

AKI - D 9 hours ago

I saw the patient in the hospital who had sepsis syndrome after abdominal surgery and subsequently AKI requiring dialysis She recovered her sepsis...

View Discussion

RE: Fibrillary GN, unresponsive to rituximab 9 hours ago

Thanks . What element of pathophysiology of this disease points to c19 as culprit? Like in this case Curious to learn Many thanks ------------...

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 9 hours ago

Relapse of AL amyloid despite stem cell transplant --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 9 hours ago

Yes relapse in context of stem cell transplant . Question is it only relapse or rejection of stem cell transplant (I don’t have knowledge on this ...

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 9 hours ago

Dr. Soobadar - What aspect of his evaluation would you point to as indicating relapse of this underlying disease-AL Amyloidosis?. --------------...

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 10 hours ago

Thanks dr Mohiuddin There is important consideration here.This this relapse of disease in stem cell transplant patient Does it also mean rejecti...

View Discussion

RE: anti gbm/mpo +ve in young female 10 hours ago

Thanks dr Asha really helpful And for boys ? @ prof glassock - thanks for your clear statement . In summary its case based approach . If someone...

View Discussion

RE: Normocalcemic Hyperparathyroidism or Idiopathic Hypercalciuria 11 hours ago

Thanks Dr Glassock and Dr Sprague. Phosphate has been normal throughout. ------------------------------ Awais Nauman HMC Doha ----------------...

View Discussion

Indolent crescentic GN 12 hours ago

Hi everyone. I need your support with this case. 49-year-old female. Since 2021, she has had progressive proteinuria, reaching up to 3.5 g/24 ...

View Discussion

RE: anti gbm/mpo +ve in young female 13 hours ago

It is more of a concern in post-pubertal girls. We routinely refer our SLE children to fertility preservation clinics and they do multiple things (...

View Discussion

RE: anti gbm/mpo +ve in young female 16 hours ago

Dr. Soobadar - you are asking guidance for declaration of futility in cases of severe anti-GBM disease with oligio-anuria, dialysis dependent kidne...

View Discussion

RE: anti gbm/mpo +ve in young female 17 hours ago

Thanks dr Asha. Is fertility a consideration at this age? And can anything be done ? --------------------------------- Muhammad Soobadar MBChB U...

View Discussion

RE: Normocalcemic Hyperparathyroidism or Idiopathic Hypercalciuria 1 day ago

I agree with Prof Glassock, this does appear to be primary HPTH. I am curious as to what his serial serum phosphates are. Since he is not overtly h...

View Discussion

RE: Gap Acidosis 1 day ago

Yes, there have been many cases of 5-OP acidosis associated with flucloxacillin, fewer with Dicloxacillin or Nafcillin – almost always in associati...

View Discussion

RE: Gap Acidosis 1 day ago

Here is a reference for PGMA coincident with flucloxacillin and paracetamol. Irani, AZ, et al . BMJ Case Rep 2021; 14: e237536. -----------------...

View Discussion

RE: Gap Acidosis 1 day ago

I was unable to find any evidence that the second generation cephalosopin has been associated with metabolic acidosis in the absence of sepsisIf yo...

View Discussion

RE: anti gbm/mpo +ve in young female 1 day ago

Combined anti-GBM and ANCA driven crescentic GN with RPGN features is quite rare in the Pediatric age population less than 8 years old, but I agree...

View Discussion

RE: anti gbm/mpo +ve in young female 1 day ago

I am a pediatric nephrologist and had a 4-year-old presenting with crescentic GN (100% crescents, mostly fibro cellular) and was double + for ANCA ...

View Discussion

RE: Gap Acidosis 1 day ago

Dont forget that the ABx Cefuroxime this patient was on also is associated with pyroglutamic acid metabolic acidosis. I guess this is perhaps combi...

View Discussion

RE: Introducing Rewired: Navigating AI's Role in Kidney Health - New ASN Podcast 2 days ago

Dr. @Richard Glassock Thank you for the recommendation. I will follow up with the team about extending the invitation. We welcome suggestions on th...

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 2 days ago

Thanks for the additional information. I feel that decision regarding need for additional plasma cell-directed therapy will have to be made by the ...

View Discussion

RE: Renal Dysfunction in a Diabetic Patient 2 days ago

Mr Zada First congratulations for looking into what ails this lady. Indeed looking into available resources is first but do not see anything wrong ...

View Discussion

RE: Normocalcemic Hyperparathyroidism or Idiopathic Hypercalciuria 2 days ago

According to the available literature , an iPTH of this magnitude woukd be seldom found in idiopathic renal hypercalciuria . The Bone Density data ...

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 2 days ago

From the data available, I don't see any need to re-institute chemotherapy. Observation only and a deeper evaluation of the extent of the hematolog...

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 2 days ago

Proteinuria, even in the Nephrotic Range, can persist for long periods (? Years) following a complete hematological remission of AL Amyloid due to ...

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 2 days ago

Kidney Biopsy on 8/26/22 was positive for renal amyloidosis. - 8/16/22 SPEP with M protein: IgA Kappa ([More]

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 2 days ago

Serum and urine IEP/IF and serum kappa:lambda light chain level results before stem-cell transplant and at present? Bone marrow findings prior to ...

View Discussion

RE: Elective Initiation of Hemodialysis in Pregnancy with Advanced CKD 2 days ago

I agree with Dr. Rodby. In my opinion, she should initiate dialysis to optimize fetal outcomes and targeting mid week BUN [More]

View Discussion

RE: Hypercalcemia in ESRD 2 days ago

I agree with most of the comments and it is most likely immobilization. Will be nice to see the 1,25 D level when it is available. I would also pre...

View Discussion

RE: Salmonella Sepsis and C3 GN???? 2 days ago

Salmonella infection has been associated with glomerulonephritis with C3 deposition, to be rare. The association manifests as post-infectious glome...

View Discussion

RE: Salmonella Sepsis and C3 GN???? 2 days ago

Apologies I meant to say there was no evidence of TMa in the initial post ... No schistocytes, normal haptoglobin, mild rise in LDH only. Will aw...

View Discussion