A case report of a young girl with recurrent hematuria: a missed diagnosis - renal nutcracker syndrome.
BMC Nephrol
; 20(1): 349, 2019 09 05.
Article
in En
| MEDLINE
| ID: mdl-31488074
ABSTRACT
BACKGROUND:
Nutcracker syndrome is an easily missed cause of hematuria in children. It is characterized by left renal vein entrapment between the abdominal aorta and the superior mesenteric artery causing renal venous hypertension. Intermittent hematuria and orthostatic proteinuria with or without abdominal or flank pain are the common clinical manifestations. Presence of variable non-specific symptoms and non-significant physical findings results in a delayed diagnosis. CASE PRESENTATION We present a ten -year -old girl with four episodes of painless gross hematuria and recurrent microscopic hematuria since the age of two years. Doppler ultrasound showed left renal vein compression while 3 D computerized tomography angiography confirmed the diagnosis of an anterior nutcracker. The patient was conservatively treated with nutritional support (pediasure complete formula and high calorie food), iron supplements and followed up, monitored for anemia, hypertension and renal insufficiency.CONCLUSION:
Nutcracker syndrome is a rare cause of recurrent gross hematuria in children. A high index of suspicion and proper imaging is needed to reach a proper diagnosis and avoid the psychological and financial stress on the family.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Renal Nutcracker Syndrome
/
Missed Diagnosis
/
Hematuria
Type of study:
Diagnostic_studies
/
Prognostic_studies
Limits:
Child
/
Female
/
Humans
Language:
En
Journal:
BMC Nephrol
Journal subject:
NEFROLOGIA
Year:
2019
Type:
Article
Affiliation country:
Yemen