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Loin pain-hematuria syndrome (LPHS) is a poorly defined disorder characterized by recurrent or persistent loin (flank) pain and hematuria that appears to represent glomerular bleeding. Most patients present with both manifestations, but some present with loin pain or hematuria alone.
Hematuria can be classified according to visibility, anatomical origin, and timing of blood during urination. [1] [6]In terms of visibility, hematuria can be visible to the naked eye (termed "gross hematuria") and may appear red or brown (sometimes referred to as tea-colored), or it can be microscopic (i.e. not visible but detected with a microscope or laboratory test).
Frank hematuria and loin pain should prompt a search for another cause, such as kidney stones or loin pain-hematuria syndrome. Also, there are no systemic manifestations, so presence of hearing impairment or visual impairment should prompt a search for hereditary nephritis such as Alport syndrome. [citation needed]
These presenting symptoms are relatively non-specific and are often seen in other glomerular disorders. Preceding upper respiratory tract infection or post-streptococcal glomerulonephritis may contribute to hematuria, as both have been identified in patients presenting with hematuria in the context of mesangial proliferative glomerulonephritis. [2]
Most patients have been reported to have gross or microscopic hematuria. [8] Significantly increased serum lactate dehydrogenase levels and proteinuria may also be observed. [7] Renal angiography is still the gold standard, but CT renal angiography, CT angiography, and DMSA radioisotope scan can also be used to establish the diagnosis. [4]
Hematuria (one of the symptoms of Nephritic syndrome Historically, nephritic syndrome has been characterized by blood in the urine ( hematuria ), high blood pressure ( hypertension ), decreased urine output <400 ml/day ( oliguria ), red blood cell casts , pyuria , and mild to moderate proteinuria .