RE: Unveiling Takayasu's Arteritis In A Young Female With Severe Hypertension 1 hour ago

What is the type of anemia (hemoglobin 8 g/dl) that she has? Normal platelet count makes TMA secondary to severe hypertension unlikely. Is she iron...

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RE: VHL and kidney transplant 1 hour ago

Dr. Sekar: Need more details. In this patient with von Hippel-Lindau disease, nephrectomy was done on both sides (total/partial) for RCC, a known c...

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VHL and kidney transplant 3 hours ago

Thanks in advance Our group has a patient-- 55 y o M with st 3b CKD (on sglt2i, ARB), MPGN many years ago RCC with left nephrectomy and partia...

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RE: Unveiling Takayasu's Arteritis In A Young Female With Severe Hypertension 4 hours ago

If IS therapy is chosen, concomitant therapy for TB will likely be required. ------------------------------ Richard Glassock MD, FASN Lagun...

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RE: Unveiling Takayasu's Arteritis In A Young Female With Severe Hypertension 4 hours ago

Given the patients youth and severity of disease, I think consideration should be given to Steroid + MMF therapy and if refractory to these agents,...

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RE: Primary vs Secondary IgAN 4 hours ago

No, I do not think so. But I guess it is possible. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -----...

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RE: Primary vs Secondary IgAN 4 hours ago

I will try to work on getting initial biopsy report. Patient presented w pancytopenia and nephritis. Do you think presence of MMF may be the ca...

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RE: Unveiling Takayasu's Arteritis In A Young Female With Severe Hypertension 5 hours ago

I haven't seen this in decades. Let's see what the experts think:@Duvuru Geetha @Peter Merkel ------------------------------ Mario Rubin,...

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RE: Primary vs Secondary IgAN 5 hours ago

There is no evidence of active lesion on light microscopy to explain worsening of proteinuria. Diagnosing IgA nephropathy in the presence of IgA de...

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Unveiling Takayasu’s Arteritis In A Young Female With Severe Hypertension 5 hours ago

An 18-years-old female was referred for evaluation of severe hypertension (BP 220/130 mmHg). She have a history of skin TB for 6 months (plaque in...

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RE: Post infective crescentic GN 6 hours ago

If this patient has persistent renal dysfunction even after 8 weeks and has persistent low C3 levels we may consider it as infection triggered C3 G...

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RE: Primary vs Secondary IgAN 9 hours ago

What did the original biopsy show with IF 2018. ? What was the basis for a diagnosis of SLE? . what is his eGFR and proteinuria now. Active IgAN wi...

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Primary vs Secondary IgAN 12 hours ago

My partner has a case which I wanted to share with forum seeking further recommendations 36yo Hispanic man with hx of SLE/SLN dx in 2018 at that...

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RE: Post infective crescentic GN 13 hours ago

Thank you for your replies. Full screening for underlying infection was performed. Similarly, wide range screening for immunological disease was pe...

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RE: Post infective crescentic GN 20 hours ago

Candida pneumonia is uncommon in immunocompetent patients. Since patient had been on other antibiotics, could have had oropharyngeal candidiasis an...

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RE: Post infective crescentic GN 20 hours ago

The evidence forc a favorable effect of immunosuppression in cases like this is very weak and inconsistent . I would likely chose further treatment...

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One Week Left - Nephrology Quiz and Questionnaire 1 day ago

There is only one week left to help contribute to the Nephrology Quiz and Questionnaire session at Kidney Week 2025. Please complete this 15-questi...

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One Week Left - Nephrology Quiz and Questionnaire 1 day ago

There is only one week left to help contribute to the Nephrology Quiz and Questionnaire session at Kidney Week 2025. Please complete this 15-questi...

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RE: Post infective crescentic GN 1 day ago

Seems like u have a case of Infection Related GN (IRGN) with , lack of IgG suggesting activation of alternate Complement pathway. As she has severe...

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RE: Post infective crescentic GN 1 day ago

Just to add the Immunoflouriscent study revealed predominenet C3 deposits. EM result is pending ------------------------------ Wael Jebur MD ...

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Post infective crescentic GN 1 day ago

52 year old lady presented to emergency department with fever and chills for few days with abdominal pain. Examination was unremarkable. Invest...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 1 day ago

Whistleblower says U.S. organ transplants corrupted by greed and bias This is so disappointing. Mt personal e mail is besaraba1943@outlook.com ...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 1 day ago

The discussion we are having is likely to become Tagged as inappropriate for the Forun, so I am writing to you from my personal e-mail. I am of U...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 1 day ago

One of the real troubling things that is happening in the Kurdish region has nothing to do with medicine or wars. The public education system is cr...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 1 day ago

As you so state, part of the problem is the "billing" department which has a temper temprum when they cannot get the bill out in a week and throws ...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 1 day ago

Thank you for your reply. Every nation needs to determine how much and to whom it must provide health care and how to provide the necessary funding...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 1 day ago

Dr. Weins I'll reply to a couple of comments that may be of general interest. I'll get in touch with you through email outside of the forum. I...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 1 day ago

The stain is an H&E. We are well experienced with Fabrys. I find the H&E just as good as special stains for identifying podocyte swelling and Zebra...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 1 day ago

Dr Basarab I,ve been in Kurdistan of Iraq 18 years since retiring in the States. In the last 10 years, the inequities in healthcare have increase...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 1 day ago

Since kidney function has improved in association with steroid therapy, it may be best to wait and see if proteinuria resolves completely and GFR n...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 1 day ago

The tubular casts are strange looking in the photomicrographs. The single glomerulus has a few intercapillary zones that look expanded and Foamy. C...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 2 days ago

How do you keep costs down? In the statws anyone on Medicare and a supplemental [p;icy is not surprised between charges and the actual pauments mad...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 2 days ago

Just wanted to chime in here. Renal Pathologist from Boston. I work on podocytopathies and anti-nephrin as well. In light of everything you say, ...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 2 days ago

At a cost of $900 we can forget that such a test as EM exists. In India we have a few centres(private labs) that do EM at a cost of ₹7000 or around...

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RE: Kidney transplantation in a patient with monoclonal C3G 2 days ago

Just an opinion, but I think the risk of recurrent Disease in a kidney transplant is too high since his monoclonal C3G is not in full remission. In...

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RE: Kidney transplantation in a patient with monoclonal C3G 2 days ago

thanks Current C3 level is slightly low at 0.6 g/L (n.v. 0.9-1.8) @Richard Glassock@Nelson Leung ------------------------------ Emilio Ventur...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 2 days ago

Retrieving EM from a paraffin block will be all right for deposits. The visceral epithelial cells do not retrieve very well, the cytoplasm deterior...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 2 days ago

I don't think that a rebiopsy is going to help very much . The diffuse podocytopathy of MCD can disappear fairly quickly after steroid therapy . Do...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 2 days ago

Dr. Glassock, yes she has edema and hyperlipidemia (LDL 350 mg/dl and TC 450 mg/dl), the biopsy was done right after 3 pulse steroid therapy. Dr. ...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 2 days ago

Dr. Hughson thanks I was aware of the use of paraffin embedded tissue for EM as a "rescue" technique to look for electron dense deposits. Can it...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 3 days ago

MCD is now suspect. Was any edema or hyperlipidemia found at presentation? The UPCR and UACR may be wrong due to AKI. Was the biopsy done after or ...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 3 days ago

Dr Hyder We will need a new biopsy for EM. One core in formalin is fine. There was no "dusting" on the glomeruli. There was no podocytopathy b...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 3 days ago

Dr Hyder We can do the EM, if there are enough glomeruli in the block. It will take about a week. I'll talk to Dr Alaa tomorrow. It is not done r...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 3 days ago

I published a study on proteinuria occurring in transplanted kidneys. Seeing that even LR kidneys had proteinuria , I wondered whether proteinuria ...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 3 days ago

Thanks all for your insightful comments. We have the opportunity to have access to do ELISA anti-nephrin antibodies and I agree it is still not st...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 3 days ago

Also If standard US was done I would perform a Doppler US to rule out renal vein thrombosis. ------------------------------ Emilio Venturelli MD...

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RE: Thoughts on immunosuppresion for canine MPGN? 3 days ago

I have an average of 6 dogs, and whenever they have a terminal illness , I prefer to euthanize them. Having said that I am amazed by the advances i...

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RE: Thoughts on immunosuppresion for canine MPGN? 3 days ago

If you were to proceed to treat this as a lupus case, you can try MMF again or if there is GI introlerance try mycophenolic acid. Apparently MPA ha...

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RE: Severe Acute Tubular Injury With Severe Nephrotic Syndrome And Presumptive MCD diagnosis 3 days ago

Dr. Aledan, please clarify: 1. Was BP markedly elevated (SS-A/SS-B positive)? 2. Type of "pathological casts" in urine (mentioned under history in ...

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RE: Lupus Case 3 days ago

I never use UACR in LN. After a Euro -Lupus CYC regimen, with a rapid PEXIVAS styled steroid taper, I would maintain on MMF (or RTX if ANCA +.). Ju...

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