Nutcracker Syndrome Associated with Non-glomerular Hematuria in Childhood / 대한신장학회잡지
Korean Journal of Nephrology
;
: 702-708, 1998.
Article
in Korean
| WPRIM
| ID: wpr-159052
ABSTRACT
PURPOSE:
This study was designed to aid the diagnosis and to predict the outcorne by understanding the clinical course of nutcracker syndrome in childhood.METHODS:
The clinical, laboratory, radiological and cystoscopic data from the medical records of eleven children who were diagnosed as nutcracker syndrome by gross hematuria and pressure gradient criteria (>3mrnHg) were studied retrospectively and analyzed.RESULTS:
Sex ratio of the cases was 74, and the median age of onset was 12.8 (3-14.3) years. Six cases showed persistent and 5 cases manifested interrnittent, exercise induced hematuria. Left flank pain (64%), abdominal pain (18%), left varicocele (9%) were associated in some of the children, but hematuria was the only symptom in 36Yo. Left renal vein entrapment was documented in 10 cases by ultrasonography. Out of the 5 cases studied by renal Doppler ultrasonography, 4 and 5 cases showed higher (>5) mean left renal vein diameter ratio (Distal/ Aortomesenteric portion) and mean peak velocity ratio respectively. Unilateral bleeding from left ureteral orifice was documented in 7 of the 9 cases at cystoscopy. The mean pressure gradient between proximal left renal vein and inferior vena cava was 4.4+/-1.6 (3-7) mmHg. Hematuria of 25% and 57% of the cases disappeared spontaneously in 3 and 5 years after onset respectively. Proteinuria disappear- ed in 3 of the 5 initial proteinuric cases.CONCLUSION:
Nutcracker syndrome must be considered in the differential diagnosis of non-glomerular, especially gross hematuria in childhood, and Doppler ultrasonography can aid diagnosis non-invasively. The renal function remained stable, but 4396 of the cases continued to show hematuria still 5 years after onset.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Proteinuria
/
Renal Veins
/
Sex Ratio
/
Ureter
/
Varicocele
/
Vena Cava, Inferior
/
Abdominal Pain
/
Medical Records
/
Retrospective Studies
/
Ultrasonography
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Child
/
Humans
Language:
Korean
Journal:
Korean Journal of Nephrology
Year:
1998
Type:
Article
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