#ECNeph @brammahin @Dilushiwijay @myadla @acssjr @dra_miliflores pubmed.ncbi.nlm.nih.... pubmed.ncbi.nlm.nih.... ☄️ More than few reported cases exist
@myadla.bsky.social
ℹ️Turns out patient has hypogammaglobulinemia ❓MMF related/disease related Ig A - 134 mg/dl ( 70-400) ⬇️Ig G - 669 mg/dL (700-1600) ⬇️⬇️Ig M - 38 mg/dL (40-230) 😏Does it explain all? #ECNeph @brammahin @Dilushiwijay @myadla @acssjr @dra_miliflores
#ECNeph @brammahin @myadla @Dilushiwijay @acssjr @dra_miliflores @Dilushiwijay @ISNkidneycare Admitted with febrile illness Flare vs infection Any other DD ? Thoughts plz ! Mild rise in creatinine Kidney Bx : Now Class III LN
#ECNeph @brammahin @myadla @ISNkidneycare @Dilushiwijay @acssjr @dra_miliflores Class switching in LN Bomback AS. Nonproliferative Forms of Lupus Nephritis: An Overview. Rheum Dis Clin North Am. 2018 Nov;44(4):561-569
Let start the discussion! 23 YO women with Lupus and recurrent admissions #ECNeph @kidneying.bsky.social @myadla.bsky.social @dilushiwijay.bsky.social @dramiliflores.bsky.social
#ECNeph @brammahin @myadla @Dilushiwijay @acssjr @dra_miliflores @Dilushiwijay @ISNkidneycare Is the diagnosis obvious ? Should we check labs? ANA+VE/low C3/hemat /Musculo skeletal involvement /Kidney Biopsy done in v/o proteinuria : Class 1 Can it be podocytopathy
Thank you for a good case prsentation @karnephro.bsky.social #ECNeph @dilushiwijay.bsky.social @theisn.org
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Shubharthi Kar@karnephro.bsky.social · last yr.Now that’s a roll! Thanks for joining tonight’s #ECNeph discussion @theisn.org @myadla.bsky.social @dramiliflores.bsky.social @arvindcanchi.bsky.social
Recent publication from CKJ @karnephro.bsky.social #ECNeph @dilushiwijay.bsky.social @theisn.org
Shubharthi Kar@karnephro.bsky.social · last yr.⚡️PLA2R antibody seropositivity doesn’t mean that we do not investigate for underlying malignancies. Here is a Case Report showing PLA2rAb MN having Carcinoma Oesophagus #ECNeph @theisn.org @myadla.bsky.social @dramiliflores.bsky.social @arvindcanchi.bsky.social
⚡️PLA2R antibody seropositivity doesn’t mean that we do not investigate for underlying malignancies. Here is a Case Report showing PLA2rAb MN having Carcinoma Oesophagus #ECNeph @theisn.org @myadla.bsky.social @dramiliflores.bsky.social @arvindcanchi.bsky.social
KDIGO recommends Population and Age-appropriate Screening for malignancies irrespective of antigen status #ECNeph @theisn.org @myadla.bsky.social @dramiliflores.bsky.social @arvindcanchi.bsky.social
Check the distribution of solid malignancies in NS @karnephro.bsky.social #ECNeph @dilushiwijay.bsky.social @theisn.org
Differentiating between PMN and SMN @karnephro.bsky.social #ECNeph @dilushiwijay.bsky.social @theisn.org
Shubharthi Kar@karnephro.bsky.social · last yr.👉 🫣 Can IF differentiate from Primary and Secondary MN? IgG 4 is the dominant class in primary MN 👉 IgG1,IgG2, IgG3 are dominant Immunoglobulins in Secondary MN #ECNeph @theisn.org @myadla.bsky.social @dramiliflores.bsky.social @arvindcanchi.bsky.social
👉 🫣 Can IF differentiate from Primary and Secondary MN? IgG 4 is the dominant class in primary MN 👉 IgG1,IgG2, IgG3 are dominant Immunoglobulins in Secondary MN #ECNeph @theisn.org @myadla.bsky.social @dramiliflores.bsky.social @arvindcanchi.bsky.social
Paraneoplastic glomerulopathies @karnephro.bsky.social #ECNeph @dilushiwijay.bsky.social @theisn.org
Shubharthi Kar@karnephro.bsky.social · last yr.👉 5-22 % of Adults having Membranous Nephropathy had been diagnosed malignancy within a few years of the MN Diagnosis 👉 Lung, Colon, Breast, Stomach, Prostate cancers are commonest www.kidney-international.org/article/S008... #ECNeph @theisn.org @myadla.bsky.social @dramiliflores.bsky.social
Some more info about PNS ! @karnephro.bsky.social #ECNeph @dilushiwijay.bsky.social @theisn.org
ISNkidneycare@theisn.org · last yr.A positive anti-PLA2R antibody test is “virtually” diagnostic of a lesion of MN (but may not always be able to reliably distinguish primary and secondary forms) #ECNeph #MedSky #NephSky @kdjhaveri.bsky.social @dramiliflores.bsky.social @karnephro.bsky.social
@karnephro.bsky.social #ECNeph @dilushiwijay.bsky.social @theisn.org Paraneoplastic glomerulopathy can occur before /sfter or simultaneously with the diagnosis of MN Need for evaluation of cases of MN for underlying malignancy is suggested
Shubharthi Kar@karnephro.bsky.social · last yr.Membranous Nephropathy and Malignancy — a deadly duo ☠️ 👉 Let’s start with some trivia ❓How many older adults develop malignancy post diagnosis of Membranous Nephropathy? A. < 1% B. 5% - 22% C. 30% - 40% D. > 50% #ECNeph @theisn.org @myadla.bsky.social @dramiliflores.bsky.social
Primary vs Secondary Membranous Nephropathy #ECNeph http://springer.com/... @dramiliflores.bsky.social @karnephro.bsky.social
🔬 The characteristic histopathologic features of MN, light microscopy, IF, EM, are falling into place. So… where are we in this case? Granular IgG, GBM thickening, no crescents... What do you think? #ECNeph @dramiliflores.bsky.social @karnephro.bsky.social www.ajkd.org/action/...
A positive anti-PLA2R antibody test is “virtually” diagnostic of a lesion of MN (but may not always be able to reliably distinguish primary and secondary forms) #ECNeph #MedSky #NephSky @kdjhaveri.bsky.social @dramiliflores.bsky.social @karnephro.bsky.social
Different types of tumor secrete different types of antigen. Here is the proposed mechanism of malignancy associated MN. #ECneph @dramiliflores.bsky.social @myadla.bsky.social @theisn.org www.frontiersin.org/journals/med...
Great infographic about NS in elderly @karnephro.bsky.social #ECNeph @dilushiwijay.bsky.social @theisn.org
ISNkidneycare@theisn.org · last yr.👀 What’s really behind the nephrotic picture in the elderly? Classic? Secondary? Something more sinister? #ECNeph @dramiliflores.bsky.social @karnephro.bsky.social Check this VA @sibbek.bsky.social
Genetic testing for elderly ? Any lit supporting this ? @karnephro.bsky.social #ECNeph @dilushiwijay.bsky.social @theisn.org
ISNkidneycare@theisn.org · last yr.🧬 Would genetic testing help at this stage? Or is it something we reserve for younger patients with nephrotic syndrome? Let’s take a closer look to the UK RaDaR Registry #ECNeph @dramiliflores.bsky.social @karnephro.bsky.social
Elderly with massive proteinuria Membranous nephropthy Amyloidosis Dn if (pt is DM) FSGS #ECNeph @karnephro.bsky.social #ECNeph @dilushiwijay.bsky.social @theisn.org
ISNkidneycare@theisn.org · last yr.🧬 24h Urine Protein: 11.44 g 📌 Severe proteinuria + hypoalbuminemia Kidneys look fine… but clearly, something’s brewing. @dramiliflores.bsky.social @karnephro.bsky.social #ECNeph
@karnephro.bsky.social #ECNeph @dilushiwijay.bsky.social @theisn.org Searching for clues .....
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Milagros Flores @dramiliflores.bsky.social · last yr.Welcome to #ECNeph 🗣️ Got any clues 4 today?
