RE: ? Cryoglobulinemic GN 7 hours ago

In this setting pronase IF may be helpful in evaluating the hyaline pseudothrombi deposits which were seen by LM but did not appear to be captured ...

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RE: ? Cryoglobulinemic GN 7 hours ago

I resonate with Dr. Venkat's analysis, but organized deposits are not typically seen in Type III cryoimmunoglobulinemia. I still would do Pronase d...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria 7 hours ago

What a great discussion of a very formidable and challenging management issue, complicated greatly by the un-Availability of Lumisarin. I sense agr...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria 8 hours ago

I am going to be hyperbolic (I dont think that is the right expression but you get the idea) here: Whatever you do do it soon, This is what hap...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria 11 hours ago

CLKT vs kidney tx results in better kidney graft survival but similar patient survival in B6 unresponsive PH Was that B6 responsive PH for which...

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RE: Question about HDF convection volume target 12 hours ago

When you ultrafilter 23L /BSA , how accurately can yoy achve the remova;of theinterdialytic fluid accumilated which can cary form 1 to 4?:. This ma...

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RE: Question about HDF convection volume target 13 hours ago

We are implementing a convection volume target of 23 liters per 1.73 BSA in our unit but we are not sure of the best target to monitor. In the best...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria 13 hours ago

Is your patients genotype B6 responsive? CLKT vs kidney tx results in better kidney graft survival but similar patient survival in B6 unresponsiv...

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RE: ? Cryoglobulinemic GN 13 hours ago

IgG and IgM3+ with negative IgA on immunofluorescence certainly suggests possibility of cryoglobulinemia , type III (given lack of monoclonality by...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria 13 hours ago

I don't have any personal experience in this area. Rapid access to and prompt availability of oxalate blood level results will be critical since ne...

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RE: ? Cryoglobulinemic GN 13 hours ago

Thanks Dr Glassock and Dr Rodby. HCV Ab and syphilis screening was negative. ANA was 0 by CMIA and neg by IFA. Our lab does not run ENA profile i...

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RE: Question about HDF convection volume target 14 hours ago

I believe in individualization, However, calculation of BSA as our normalization factor for persons of different weight and height but same gender ...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria 14 hours ago

Sequential liver followed by kidney transplant would be the better option for him at this age. One of the advantages is that the same donor (if wil...

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RE: Microscopic hematuria 14 hours ago

Was the urine microscopic organisms examination done with automated devise or manually as automated devise may miss dysmorphic or lysed RBCs -----...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria 14 hours ago

Contrary to DDT, kidney and liver grafts will be obtained from different donors in LDT. So it seems appropriate to do liver transplantation followe...

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Question about HDF convection volume target 17 hours ago

We are implementing a convection volume target of 23 liters per 1.73 BSA in our unit but we are not sure of the best target to monitor. In the best...

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RE: Microscopic hematuria 20 hours ago

I think we must proceed ;in addition to follow up, for other tests like Ca/Cr ratio, urine c/s ,Hb electrophoresis, coagulation studies in additi...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria 21 hours ago

unfortunately, We Don't have access to Lumisarin ------------------------------ Ahmed Emara MD, FASN Ain shams university, cairo Cairo ---------...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria 23 hours ago

I do not have an answer to this question, but it may be an important one. In an era of Lumisarin and Pyridoxine therapy for Primary Type1 Hyperoxal...

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RE: minimal change disease steroid dependent 1 day ago

thank you , will ask pathologist to relook again. ------------------------------ Shivangi Patel Nephrology Morristown NJ ---------------------...

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RE: minimal change disease steroid dependent 1 day ago

We can also see "dusting" of IgG on podocyte cytoplasm with conventional IF in many cases suggestive of an anti-podocyte antibody (nephrin or other...

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Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria 1 day ago

I would greatly appreciate your opinion on a complex case we are currently managing. We have a 22-year-old male diagnosed with end-stage kidney dis...

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RE: Microscopic hematuria 1 day ago

The pediatricians who cared for the patient til the age of 18 probably never considered genetic testing since the family history was negative. Pers...

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RE: Microscopic hematuria 1 day ago

We have no indication of hereditary disease, both parents and a sibling have been examined. Means there urine I believe But believe no genetic tes...

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RE: ? Cryoglobulinemic GN 1 day ago

I agree tgat a palmar rash demands a search for secondary Syphillis . ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (...

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RE: ? Cryoglobulinemic GN 1 day ago

Clinical features, Low C4, slightly low C3, LM and IF findings suggest Type II mixed Cryoglobulinemia . But normal RF , organized deposits is more ...

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RE: Microscopic hematuria 1 day ago

Urine hemoglobin 3+ positive, microscopic urine sediments negative for red blood cells = hemoglobinuria or myoglobinuria unless the urine sediment ...

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RE: Microscopic hematuria 1 day ago

microscopic blood only since childhood but: nl BP minimal proteinuria at best nl creatinine I would not biopsy (yet) but I would get genet...

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RE: ? Cryoglobulinemic GN 1 day ago

palmar rash better check for syphillis, pathology atypical but cant miss that... Cryo with a negative RF has to be unusual I agree, I kinda doubt...

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RE: Microscopic hematuria 1 day ago

I agree with Dr Glassock that PNH has to be excluded Below is an abstract from a recent publication Pathogenesis of paroxysmal nocturnal hemog...

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RE: Microscopic hematuria 1 day ago

Thanks for your input. The upper limit for UACR at our lab is 3,0. We will check both LD and CK and also a fresh urinary sediment. --------------...

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? Cryoglobulinemic GN 1 day ago

Will appreciate community's opinion: 37 years old man referred for hematuria and proteinuria. No arthralgia, skin rash or oral ulcers. Cigaret...

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RE: C3 or IgA 1 day ago

Going back to the initial presentation of isolated hematuria, and a sediment without elevated erythrocytes but positive test on dipstick, I would t...

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RE: Microscopic hematuria 1 day ago

If this is l hemoglobinuria, not hematuria a search for the cause of hemolysis is in order-like paroxsysmal nocturnal hemoglobinuria. -----------...

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RE: Microscopic hematuria 1 day ago

Interesting - so no confirmed hematuria -only hemoglobinuria /myoglobinuria. What are the units for UACR? A fresh urine sediment needs ri be examin...

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RE: Microscopic hematuria 1 day ago

Thank you Dr Glassock for your quick answer! An ultrasound two years ago was unremarkable and so was the urinary sediment with no red blood cells, ...

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RE: Microscopic hematuria 1 day ago

What are the morphological characteristics if the hematuria-dysmorphic or normomorphic? What are the results of UACR and CT-Urogram . Negative wh...

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Microscopic hematuria 1 day ago

Dear Colleagues, i would like to hear your opinion concerning an 18-year old male with persistent heamaturia since early childhood. He has no pro...

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RE: C3 or IgA 1 day ago

With no morphological or clinical findings of recurrent IgAN or C3G, I would manage him conservatively, with another transplant biopsy at 1 years. ...

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RE: C3 or IgA 1 day ago

When labels are confusing we go back to the pathobiology of the disease. This appear to be antibody mediated disease with complement activation. Tr...

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RE: C3 or IgA 1 day ago

Hello, just to summarize this case , as we have had a lot of suggestions and comments ... Any final thoughts or recommendations .. thanks -------...

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RE: minimal change disease steroid dependent 1 day ago

Addendum- it appears that a confocal IF microscopy showing redistribution of nephrin and colocalization of IgG can be equivalent to a positive seru...

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RE: minimal change disease steroid dependent 2 days ago

It should be stressed that no commercial FDA-approved anti-nephrin antibody test is available on demand anywhere Just yet. ---------------------...

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RE: minimal change disease steroid dependent 2 days ago

70% is much improved over early reports this is great news, very encouraging thanks ------------------------------ Roger Rodby MD, FASN...

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RE: minimal change disease steroid dependent 2 days ago

In my opinion, we will see "MCD" evolve as a "pattern of injury", not a diagnosis, much like MN, except t evolution will be driven by serology not ...

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RE: minimal change disease steroid dependent 2 days ago

Still there are a lot of non-anti-nephrin Ab MCD cases out there. >50% I believe? I wonder if it is still a problem with sensitivity, or will th...

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RE: minimal change disease steroid dependent 3 days ago

thank you for feedback, will keep everyone posted . Sent from my iPhone

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RE: minimal change disease steroid dependent 3 days ago

I fully agree with and support the preferential use of RTX in this case. Insurance coverage can be an issue in some localities. A favorable initi...

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RE: minimal change disease steroid dependent 3 days ago

There is enough evidence of Ritux efficacy to use it as initial therapy for MCD without steroids. ritux monotherapy Ritux Monotherapy ----...

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RE: minimal change disease steroid dependent 3 days ago

rituxaan rituxan and assuming you were still in remission at 6 months I would give another 1 gram at that point I know one Mayo MD that give...

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