Nutcracker syndrome - a rare cause of gross hematuria in children: A case report
Main Article Content
Abstract
Nutcracker syndrome (NCS) is a condition where the left renal vein is entrapped between the abdominal aorta and the superior mesenteric artery. This is a rare disease in children, and early diagnosis is crucial to avoid serious complications such as anemia or renal vein thrombosis. Common symptoms of NCS include the "Triad symptoms" of hematuria, proteinuria, and flank pain. We report the case of a 14-year-old healthy female admitted to the hospital with gross hematuria, left flank pain, no fever, no edema, and normal blood pressure. Laboratory tests showed no anemia, normal platelets, and normal basic coagulation. Blood urea, creatinine, C3, and C4 levels were normal. Urine tests revealed many red blood cells, leukocytes in urine (+), and urinary protein/creatinine ratios of 486 mg/mmol during the day, and 176 mg/mmol during the night. An abdominal CT scan showed the characteristic Nutcracker image. This case highlights a rare cause of gross hematuria in children, without edema and negative diagnostic tests suggesting hematuria of a renal origin requiring computed tomography to confirm the diagnosis of nutcracker syndrome.
Article Details
Keywords
Nutcracker syndrome, gross hemauria, children
References
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