RE: SIADH in a patient with SAH 6 hours ago

just copy your message and repost it in a new post under create ------------------------------ Roger Rodby MD, FASN Professor of Medicine Ru...

View Discussion

RE: SIADH in a patient with SAH 8 hours ago

Will try; if only I knew precisely how to correct the error. Sent from my iPhone

View Discussion

RE: Progressive IgA 9 hours ago

Unfortunately ,these are "fire-walled" reports so one cannot access the details without a Journal subscription. It is noteworthy that this patient ...

View Discussion

RE: SIADH in a patient with SAH 10 hours ago

Dr. Tijani- Could you please delete this case from this thread and repost it as a new post. It is very confusing to try to discuss two very diffe...

View Discussion

RE: Progressive IgA 10 hours ago

I know this is "from left field" but does the "smudgy " deposits of IgA make Fibrillary GN a very remote possibility? No EM performed. If a DNAJB9 ...

View Discussion

RE: Progressive IgA 10 hours ago

Good point. I have no personal experience with Eculizumab in progressive IgAN . Does the degree of chronic changes in this biopsy make one skeptica...

View Discussion

RE: Double positive ANCA 10 hours ago

This is undoubtedly a case of Hydralazine induced vasculitis- full or partial recovery is expected with permanent discontinuance of Hydralazine . A...

View Discussion

RE: SIADH in a patient with SAH 11 hours ago

What is or was the volume status , was he euvolemic or hypovolemic . You mentioned his Una being 150 mmol/l , but what was his daily urine volume ...

View Discussion

RE: Progressive IgA 11 hours ago

Few case reports for use of Eculizumab , in severe progressive , steroid resistant IgAN https://www.amjtransplant.org/article/S1600-6135(23)00519...

View Discussion

RE: Double positive ANCA 11 hours ago

This chart is self explanatory ------------------------------ Dr. Hormaz Dastoor. MD, FASN Nephrology Consultant - Seha Kidney Care. Nephrology C...

View Discussion

RE: SIADH in a patient with SAH 12 hours ago

Help needed: 60 WM, retired air traffic contractor with FAA (helped in upgrading control towers). H/o CKD (baseline SCr 1.5; presumed from DM, H...

View Discussion

RE: Double positive ANCA 12 hours ago

Yes, I was able to have a family member bring in her medications and she is on hydralazine My understanding is that with her renal failure to trea...

View Discussion

RE: Progressive IgA 14 hours ago

He and his Family deny skin rash , abdominal pain/GI bleeding, and Joint symptoms on review ------------------------------ Alamri MD ----------...

View Discussion

RE: Progressive IgA 15 hours ago

How confident are you that this is not IgA Vasculitis? Is there any history of skin rashes, abdominal pain or arthralgias. . If yes, I might consid...

View Discussion

RE: Progressive IgA 15 hours ago

With only 1 crescent in 12 non-sclerotic glomeruli and a course of declining GFR over 7 months I do not think this is RPGN with extensive crescents...

View Discussion

RE: Progressive IgA 17 hours ago

So Dr. Glassock, you are suggesting optimizing his antiproteinuric medications and to keep him on maximally supportive therapy Do you have any...

View Discussion

RE: Double positive ANCA 1 day ago

Any hydralazine or allopurinol use in this patient ? --------------------------------- Edgard Wehbe MD, FASN Wichita Nephrology Group Wichita K...

View Discussion

RE: Double positive ANCA 1 day ago

At least TMA excluded and auto-immune Hemolytic anemic present. What is the medication list? ------------------------------ Richard Glassock MD, ...

View Discussion

RE: How would you treat: Non-lupus "full house" nephropathy 1 day ago

Celiac disease linked to non-PLA2R MN is well described and due to NELL-1 MN in at least one case, (which might have been due to concomitant Alpha-...

View Discussion

RE: Double positive ANCA 1 day ago

The haptoglobin 77, LDH 226, retic 3.7%, TB .6, anti histone aby pending. +DAT complement and IgG positive. --------------------------------- J G...

View Discussion

How would you treat: Non-lupus "full house" nephropathy 1 day ago

Dear all, Greetings from Sydney - I'd value your opinion on a glomerular disease case I'm grappling with: 60M diagnosed with Coeliac disease, c...

View Discussion

RE: Double positive ANCA 1 day ago

Pretty "classic" presentation for Hydralazine-induced Vasculitis . Was he receiving this agent? If not the DD is fairly long. . What is the Rheumat...

View Discussion

Double positive ANCA 1 day ago

85yo with autoimmune hepatitis on imuran for many years who was admitted with 3 weeks UrI symptoms similar to her sister who lives with her, but sh...

View Discussion

RE: Progressive IgA 1 day ago

Thank you for your reply He appears to have excess adiposity (chubby) rather than muscular. His weight is 84 kg and height is 163 cm Unfort...

View Discussion

RE: Progressive IgA 1 day ago

Is he muscular or have excess adiposity? What is the waist circumference height ratio? We need this to better asses the level of kidney function. A...

View Discussion

RE: Progressive IgA 1 day ago

Very difficult case . He may well have progressed too far for any therapy to be effective. He may not qualify for Iptacopan therapy based on age an...

View Discussion

Progressive IgA 1 day ago

I appreciate you input with this case A 16-year-old male (weight 84 kg, BMI 31). His baseline creatinine was 89 µmol/L (April 2024), then rose t...

View Discussion

RE: Hepatitis D in dialysis 1 day ago

Thanks for the FU. Perplexing issue. No real guidelines. The only patient situation at high risk of nosocomial transmission of HDV infection in a d...

View Discussion

RE: Hyponatremia Dilemma 1 day ago

In Hyponatremia is it not necessary to check BOTH serum and urine osmolarity, urine sodium all at the same time ( virgin blood and urine sample) be...

View Discussion

RE: Hepatitis D in dialysis 1 day ago

Thanks Dr Glassock, A few in the HBV cohort are on treatment for various indications (I understand there is plenty debate in the field around pat...

View Discussion

RE: PGNMID vs Primary IC- MPGN 2 days ago

Thank you for your responses and very insightful . I have our pathologist and we dont have IgG subclass stains , he will try to procure them ( coul...

View Discussion

RE: Biopsy - help needed with interpretation 2 days ago

thank you for your detailed responses . Since the biopsy was read at a center in another country ( Kingdom of Bahrain ) - i have asked them to co...

View Discussion

RE: Biopsy - help needed with interpretation 2 days ago

It would be good to get a bit more information from the pathologists. (1) What is the nature of the IgG vs IgA staining. By IF IgG is 2+ and IgA is...

View Discussion

RE: PGNMID vs Primary IC- MPGN 2 days ago

Dr Dastoor this is most likely PGNMID recent studies that performed light chain repertoire sequentiation suggest that the majority of this disea...

View Discussion

RE: Ciclosporin dependent FSGS 2 days ago

I forgot the attachment. I'll also attach a 2002 article that is a bit historical. It reviews the evidence for PLEX with TTP. Notably, the one cond...

View Discussion

RE: Ciclosporin dependent FSGS 2 days ago

Just a small point. In the the USA, the FDA has approved the use of Lipid Apheresis for the therapy of multi-drug resistant Primary FSGS both adult...

View Discussion

RE: Ciclosporin dependent FSGS 2 days ago

I think you have raised an important issue. I had been involved in therapeutic plasmapheresis for a number of years during its early applications. ...

View Discussion

RE: Biopsy - help needed with interpretation 2 days ago

The description of the biopsy won't fit IgAN since IgA is not predominant. Kappa is only 2+. As you know, kappa will be stronger than lambda. If Ka...

View Discussion

RE: PGNMID vs Primary IC- MPGN 3 days ago

You succinctly discuss the recent changes in our understanding of PGNMID. It does seem that the underlying pathophysiology of this "pattern of inju...

View Discussion

RE: PGNMID vs Primary IC- MPGN 3 days ago

@Richard Glassock I had a discussion with some European colleagues on this case . There seems to be a shift with PGNMID , thinking of it not as a c...

View Discussion

RE: Biopsy - help needed with interpretation 3 days ago

From a frequentist standpoint this is most likely IgAN superimposed on background of DN, but your concerns about PGNMID are justified because of La...

View Discussion

RE: Ciclosporin dependent FSGS 3 days ago

Dr Soobadar-This is a new case post. Please present the detailed clinical findings as a specific new post so we do not get confused with the curren...

View Discussion

RE: Plar2 +ve With Stroke 3 days ago

In light of the new anti-PLA2R antibody serological information, MN is very likely, but kidney biopsy relatively contraindicated. We need to urgent...

View Discussion

RE: Plar2 +ve With Stroke 3 days ago

Hi prof glassock Ifa is positive 10000 Liver team there is low risk of hcc Bw --------------------------------- Muhammad Soobadar MBChB UK -...

View Discussion

RE: Ciclosporin dependent FSGS 3 days ago

Sorry similar theme question - in minimal change disease/fsgs - multiple relapse and now established on cyclosporin/steroid since June 23 and no re...

View Discussion

RE: Onconeph case Thursday, November 27 @ 8:03 PM

Thanks --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

Biopsy - help needed with interpretation Thursday, November 27 @ 1:59 PM

Dear Colleagues .. I apologise for the poor quality of the attachment and the frequent requests for feedbacks and opinions . As we live in a smal...

View Discussion

RE: Iptacopan Dosing issues Thursday, November 27 @ 1:46 PM

You are correct. It is actually the Complement AP functional (AH50) activity that is low should be less than 10% with proper iptacopan exposure. ...

View Discussion

RE: Iptacopan Dosing issues Thursday, November 27 @ 1:36 PM

I have ordered C5b-9 and Factor Bb , as both Factor Bb and sC5b-9 would be expected to decrease from baseline due to inhibition of the alternate pa...

View Discussion

RE: IgA Nephropathy with ?RPGN Thursday, November 27 @ 10:43 AM

It is such a desperate situation for sure! May take advantage of dialysis access and try few sessions of plasma exchange in between. Followed by go...

View Discussion