Loin pain hematuria syndrome

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Loin pain hematuria syndrome (LPHS) is a rare medical condition characterized by severe, unexplained flank pain (loin pain) and hematuria (blood in the urine). The syndrome primarily affects young adults and can lead to significant morbidity due to chronic pain and recurrent episodes of hematuria.

Presentation

Patients with LPHS typically present with severe, unilateral or bilateral flank pain that can be constant or intermittent. The pain is often described as sharp, stabbing, or throbbing and can be debilitating. Hematuria, which may be visible (gross hematuria) or detectable only under a microscope (microscopic hematuria), is a hallmark of the condition. Other symptoms may include nausea, vomiting, and fatigue.

Etiology

The exact cause of LPHS is unknown. Several theories have been proposed, including:

• Vascular abnormalities in the kidneys
• Glomerular disease
• Urological disorders
• Autoimmune disorders

Diagnosis

The diagnosis of LPHS is primarily clinical, based on the characteristic symptoms of loin pain and hematuria. Diagnostic tests may include:

• Urinalysis to detect hematuria
• Imaging studies such as ultrasound, CT scan, or MRI to rule out other causes of flank pain and hematuria
• Renal biopsy in some cases to exclude other renal pathologies

Management

Management of LPHS is challenging and often requires a multidisciplinary approach. Treatment options may include:

• Pain management with analgesics, including nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids
• Nerve blocks or neurostimulation techniques
• Surgical interventions such as renal denervation or nephrectomy in severe cases
• Supportive care and psychological support

Prognosis

The prognosis of LPHS varies. Some patients may experience spontaneous resolution of symptoms, while others may have chronic, persistent pain and recurrent hematuria. The condition can significantly impact the quality of life and may lead to depression and anxiety.

Related Pages

• Flank pain
• Hematuria
• Renal biopsy
• Pain management
• Nephrectomy