ESPN 51th Annual Meeting

ESPN 2018


 
What is the clinical significance of nutcracker syndrome in childhood?
SEÇIL ARSLANSOYU ÇAMLAR 1 EREN SOYALTIN 1 CANER ALPASLAN 1 ÖNDER YAVAŞCAN 1 DEMET ALAYGUT 1 FATMA MUTLUBAS 1 BELDE KASAP DEMIR 2

1- IZMIR TEPECIK TRAINING AND RESEARCH HOSPITAL DEPARTMENT OF PEDIATRICS DIVISION OF NEPHROLOGY, İZMIR, TURKEY
2- IZMIR KATIP ÇELEBI UNIVERSITY DEPARTMENT OF PEDIATRICS DIVISION OF NEPHROLOGY, IZMIR, TURKEY
 
Introduction:

The nutcracker syndrome (NCS), is used for patients with clinical symptoms associated with compression of the left renal vein, commonly between the aorta and superior mesenteric artery. We aimed to evaluate the clinical properties of patients with NCS.

Material and methods:

The medical records of the patients with NCS were evaluated retrospectively.  Age, gender, presenting symptoms, body mass indexes and other physical examination finding (hypertension / varicoles), associated renal and other disease and follow up duration were reported. Urinalysis findings,  Doppler ultrasound findings and if performed computed tomography angiography findings were analysed.

Results:

There were 26 patients; 16 female (62%) and 10 (38%) male patients, mean age 12±4.1(4-18) years. Follow up duration of  Orthostatic proteinuria was detected in 9 (35%) patients. Others presenting symptoms were microscobic hematuria in 10 (38%) patients, macroscobic hematuria in 7 (27%). Five patients presented with 1 or >1 symptoms. Two patients had posterior NCS. Two patients were followed up with Henoch-Schönlein nephritis and one patient was diagnosed as tubulointerstitial nephritis. Computed tomography used to support the diagnosis only in two patients. Surgery was planned in a patient with severe abdominal pain.

Conclusions:

Despite the rarity of NCS, diagnosis should be considered in the presence of hematuria or ortostatic proteinuria despite of other associated renal pathologies.