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immunology

What are T-regs?

The term “T-regs” is shorthand for “regulatory T-cells”–a subpopulation of T-cells which act to suppress immune system activation and promote tolerance towards self-antigens.  Although the existence of T-regs was felt to be controversial up until relatively recently, the…

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Dialyzer Reactions

Dialyzer reactions can be classified into two types: “Type A” and “Type B”.Simplistically stated, one is serious and the other one isn’t. A good pneumonic I recently learned from Dr. Daniel Coyne of Washington University-St. Louis at a…

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Useful Autoantibodies in Lupus Nephritis

Quick review of the autoantibodies that may be useful in the diagnosis and management of patients with lupus-related kidney disease: anti-nuclear antibody (ANA):  as well as know from our internal medicine days:  very sensitive, but not very specific….

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Serum Free Light Chain Assay

The dilemma:  there are a subset of patients with some type of paraproteinemia–e.g., light chain deposition disease or amyloidosis, for instance–which are NEGATIVE by SPEP & UPEP.  When there is renal involvement, the diagnosis can potentially be made…

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Combined Kidney/Bone Marrow Transplants

One of the interesting ongoing protocols at the Massachusetts General Hospital Kidney Transplant Program is the combined kidney/bone marrow transplant protocol. The idea here is to transplant both kidney & hematopoeitic stem cells from the same donor, which…

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ABO Incompatibility Renal Transplant

Although the traditional dogma of kidney transplant would state that ABO incompatibility is an absolute contraindication for a kidney transplant, this is changing:  there are some overall favorable reports of graft longevity in Japan, where cadaveric kidneys are…

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Abatacept

A relatively new immunosuppressant agent–originally approved for treatment of refractory rheumatoid arthritis but now gaining steam as an anti-rejection medication for kidney transplant recipients–is abatacept (marketed under the trade name Orencia by Bristol-Myers-Squibb. Its mechanism of action is…

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