Nutcracker syndrome with urolithiasis

Altugan, F. Şemsa; Ekı̇m, Mesı̇ha; Fítöz, Suat; Özçakar, Z. Bı̇rsı̇n; Burgu, Berk; Yalçınkaya, Fatoş; Soygür, Tarkan

doi:10.1016/j.jpurol.2010.05.014

Cited by 8 publications

(3 citation statements)

References 22 publications

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“…The onset of proteinuria in this syndrome may demonstrate a similar mechanism of mechanical forces developing at the glomerulus due to renal or iliac vein stenosis in the posttransplant period that can act as a stress signal to the podocytes and cause foot process retraction in order to avoid further damage [ 6 , 7 ]. Renal biopsy findings by electron microscopy in nutcracker syndrome complicated with proteinuria did not exhibit podocyte foot process effacement, although the small number of case reports with available electron microscopy reports and the intermittent nature of renal vein compression do not allow us to draw any definite conclusions [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Minimal Change Disease as a Secondary and Reversible Event of a Renal Transplant Case with Systemic Lupus Erythematosus

Gkrouzman

Kirou

Seshan

et al. 2015

Case Reports in Nephrology

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Secondary causes of minimal change disease (MCD) account for a minority of cases compared to its primary or idiopathic form and provide ground for consideration of common mechanisms of pathogenesis. In this paper we report a case of a 27-year-old Latina woman, a renal transplant recipient with systemic lupus erythematosus (SLE), who developed nephrotic range proteinuria 6 months after transplantation. The patient had recurrent acute renal failure and multiple biopsies were consistent with MCD. However, she lacked any other features of the typical nephrotic syndrome. An angiogram revealed a right external iliac vein stenosis in the region of renal vein anastomosis, which when restored resulted in normalization of creatinine and relief from proteinuria. We report a rare case of MCD developing secondary to iliac vein stenosis in a renal transplant recipient with SLE. Additionally we suggest that, in the event of biopsy-proven MCD presenting as an atypical nephrotic syndrome, alternative or secondary, potentially reversible, causes should be considered and explored.

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Section: Discussionmentioning

confidence: 99%

Minimal Change Disease as a Secondary and Reversible Event of a Renal Transplant Case with Systemic Lupus Erythematosus

Gkrouzman

Kirou

Seshan

et al. 2015

Case Reports in Nephrology

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“…The symptoms of autonomic dysfunction such as hypotension, syncope, and tachycardia could be seen but they are rare [14] . Henoch-Schönlein purpura, IgA, nephropathy, membranous nephropathy, and idiopathic hypercalciuria with nephrolithiasis associated with NCS have been reported [12,15] . NCS can differentiate clinically into 2 subtypes as follows: typical presentation (or renal presentation) and atypical presentation (or urologic presentation).…”

Section: Clinical Featuresmentioning

confidence: 99%

Nutcracker syndrome

Gulleroglu

Gülleroğlu

Baskın

2014

WJN

128

163

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The nutcracker phenomenon [left renal vein (LRV) entrapment syndrome] refers to compression of the LRV most commonly between abdominal aorta and superior mesenteric artery. Term of nutcracker syndrome (NCS) is used for patients with clinical symptoms associated with nutcracker anatomy. LRV entrapment divided into 2 types: anterior and posterior. Posterior and right-sided NCSs are rare conditions. The symptoms vary from asymptomatic hematuria to severe pelvic congestion. Symptoms include hematuria, orthostatic proteinuria, flank pain, abdominal pain, varicocele, dyspareunia, dysmenorrhea, fatigue and orthostatic intolerance. Existence of the clinical features constitutes a basis for the diagnosis. Several imaging methods such as Doppler ultrasonography, computed tomography angiography, magnetic resonance angiography and retrograde venography are used to diagnose NCS. The management of NCS depends upon the clinical presentation and the severity of the LRV hypertension. The treatment options are ranged from surveillance to nephrectomy. Treatment decision should be based on the severity of symptoms and their expected reversibility with regard to patient's age and the stage of the syndrome.

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“…Neben der unspezifischen abdominellen Symptomatik zeigten je 13 % Dysurie und Pollakisurie, eine Hämaturie fand er nicht [47]. Bei Flankenschmerzen sollte auch bei fehlender Hämaturie und Proteinurie an ein Nussknackersyndrom gedacht werden [47,48]. Diagnostik Zusätzlich zur morphologischen Aufweitung des betroffenen Venensystems misst die funktionelle Farbdopplersonografie pathologische Druckgradienten zwischen der Nierenvene und der inferioren Vena cava (▶Abb.…”

Section: Nussknacker Syndromunclassified

Akute Flankenschmerzen im Kindes- und Jugendalter

Ebert¹

2017

Aktuel Urol

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Nutcracker syndrome with urolithiasis

Cited by 8 publications

References 22 publications

Minimal Change Disease as a Secondary and Reversible Event of a Renal Transplant Case with Systemic Lupus Erythematosus

Minimal Change Disease as a Secondary and Reversible Event of a Renal Transplant Case with Systemic Lupus Erythematosus

Nutcracker syndrome

Akute Flankenschmerzen im Kindes- und Jugendalter

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