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crescentic glomerulonephritis

Renal Grand Rounds: Correlate Clinically

I recently presented the case of a middle-aged patient with ESRD secondary to Goodpasture syndrome. She presented with AKI 3 months after a kidney transplant. Her creatinine had normalized to 0.9mg/dl post-transplant. However, over the next few months…

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When IgA-ttacks!

To many of us IgA nephropathy (IgAN) is a disease to be watched and monitored.  Most cases of IgAN in which the clinical course is aggressive occur with one of two atypical presentations: 1. Acute kidney injury (AKI)…

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Churg-Strauss Syndrome

Churg-Strauss Syndrome lies within the spectrum of Wegener’s Granulomatosis, microscopic polyangiitis, and ANCA-associated vasculitis: all diseases which result from inflammation of small-to-medium-sized vessels. The “classic triad” of Churg-Strauss syndrome is asthma, eosinophilia, and vasculitis, and although “renal involvement”…

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Empiric Management of Suspected RPGN

RPGN is a nephrologic emergency, and one of the more exciting consult cases for nephrologists to participate in.  Much like dealing with a stroke or heart attack, delays in initiating therapy can lead to substantially worsened outcomes.  Prompt…

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A 3rd ANCA Subtype: LAMP-2

We all know about the p-ANCA and the c-ANCA, which are antibodies against either myeloperoxidase (MPO) or proteinase-3 (PR3), respectively.  Now get ready for a 3rd ANCA subtype, an antibody against LAMP-2! In a recent Nature Medicine article…

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Double Antibody Disease

The incidence of ANCA-positive disease is in the ballpark of 1:10,000. The incidence of anti-GBM disease is even more rare, at about 1:1,000,000. One would expect if these 2 disease-causing antibodies were entirely independent of one another, the…

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Churg-Strauss Syndrome

There is a patient now on the renal consult service with Churg-Strauss Syndrome. This disease falls under the category of “small vessel vasculitis” and most commonly is thought of as a pulmonary disease, as the characteristic triad consists…

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ANCA Madness

ANCA-positive vasculitides are a not uncommon cause of rapidly progressive glomerulonephritis. When we send off an ANCA test, what are we actually measuring? ANCAs (anti-neutrophil cytoplasmic antibodies) are a type of IgG autoantibodies that are directed against antigens…

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