A Case of Polyneuropathy and Proteinuria

Gerald B. Appel, MD: Welcome to the ASN 2006 CPC. The CPC is always a major challenge. The CPC is not to see if the clinician gets the answer right. It's his thought process that counts—to see if his thought process matches your thought process.We have the right people here today. We have two colleagues who will be doing this CPC today. First, Dr. Steve Korbet from Rush University Medical Center in Chicago, our clinician, who we will put to the test to see his clinical smarts and thought process. Working hand in hand with him, we have Dr. Steve Bonsib from Indiana University. So let's get started with the Midwestern group of presenters we have here.Steve Korbet: It's a pleasure to be a part of this CPC. Dr. Bonsib and I have a little history. I have been involved in doing CPC-like vignettes with him at previous ASNs and at his institution as a visiting professor in Indianapolis. My diagnostic success rate has not been too good, one for seven I believe, and I'm sure today will be no different. Dr. Bonsib will no doubt prove again that the gift of the renal biopsy given to us some 50 yr ago by Iversen and Brun in Denmark and Kark and Muehrcke here in the United States is still as precious and valuable in managing patients and guiding therapy as it was 50 yr ago (1–3). I think that one thing we can count on, whether I get the case right or not, is that the clinical value of the renal biopsy remains immeasurable.I was asked to do the CPC by Dr. Paul Kimmel some months ago. On August 15, 2006, I received an e-mail with the case which read, “Please call or write if …