Haematuria without diagnosis? Think about the rare causes…

2021 ◽  
Vol 14 (4) ◽  
pp. e240228
Author(s):  
Ana Sofia Esteireiro ◽  
Pedro Santos ◽  
Anabela Bicho
Keyword(s):  
Physical Examination ◽  
Left Renal Vein ◽  
Vital Signs ◽  
Spontaneous Resolution ◽  
Lumbar Pain ◽  
Nutcracker Syndrome ◽  
Paediatric Nephrology ◽  
Macroscopic Haematuria ◽  
History Of ◽  
High Level

We describe a case of a 17-year-old man admitted in the emergency room with a 2-month history of intermittent macroscopic haematuria and left lumbar pain. Physical examination and vital signs were normal. Investigation indicated a recurrent non-glomerular haematuria. The Doppler ultrasound revealed a compression of the left renal vein with upstream dilatation which was subsequently confirmed by CT angiography. These findings are in keeping with a case of nutcracker syndrome (NutS). Although asymptomatic in most cases, it can be a rare cause of haematuria. The teenager was referred to paediatric nephrology and was treated conservatively with spontaneous resolution of macroscopic haematuria. With this case, we would like to highlight that in children or adolescents with haematuria without an apparent cause, a high level of suspicion and appropriate imaging are necessary for the diagnosis of NutS.

Man with bilateral inguinal lymphadenopathy

2018 ◽  
Vol 35 (8) ◽  
pp. 522.1-522
Author(s):  
Charlotte Delcourt ◽  
Jean Cyr Yombi ◽  
Halil Yildiz
Keyword(s):  
Lymph Node ◽  
Physical Examination ◽  
Sexual Intercourse ◽  
Vital Signs ◽  
List Type ◽  
Cat Scratch Disease ◽  
Night Sweats ◽  
History Of ◽  
Inguinal Lymphadenopathy ◽  
Lymph Node Tuberculosis

Clinical introductionA 37-year-old man with history of lymph node tuberculosis presented with bilateral inguinal swelling with night sweats but no fever for 2 weeks. He had a cat but he had no history of scratches. He had an extraconjugal sexual intercourse a few weeks before. Physical examination revealed 5 cm tender, erythematous and painful bilateral inguinal adenopathy (figure 1A) and a small ulceration at the base of the penis (figure 1B). Vital signs were normal.Figure 1(A) Inguinal lymphadenopathy. (B) Ulceration at the base of the penis.QuestionWhat is the most likely diagnosis?ToxoplasmosisTuberculosisCat-scratch diseaseLymphogranuloma venereumSyphilis

A case of Fournier’s gangrene diagnosed with POCUS

POCUS Journal ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 3
Author(s):  
Marco Badinella Martini, MD ◽  
Antonello Iacobucci, MD
Keyword(s):  
Type 2 Diabetes ◽  
Emergency Department ◽  
Alzheimer Disease ◽  
Physical Examination ◽  
Subcutaneous Emphysema ◽  
Vital Signs ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
History Of

An 87-year-old man with a history of type 2 diabetes and severe Alzheimer disease was admitted to the emergency department with a lesion of the perineum for two days. The patient appeared agitated and not collaborating on the visit. His vital signs were normal. Physical examination revealed an edematous, suppurative, and foul-smelling perineal-scrotal lesion, with possible subcutaneous emphysema.

scholarly journals Nutcracker syndrome accompanied by hypertension: a case report and literature review

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098573
Author(s):  
Rui-feng Wang ◽  
Chun-ze Zhou ◽  
Yu-qin Fu ◽  
Wei-fu Lv
Keyword(s):  
Renal Vein ◽  
Clinical Symptoms ◽  
Color Doppler ◽  
Left Renal Vein ◽  
Plasma Renin ◽  
Color Doppler Ultrasound ◽  
Secondary Hypertension ◽  
Flank Pain ◽  
Nutcracker Syndrome ◽  
History Of

Nutcracker syndrome (NCS) refers to characteristic clinical symptoms that develop secondary to the nutcracker phenomenon (NCP), defined as compression of the left renal vein between the superior mesenteric artery and the aorta. A 22-year-old Chinese man presented with a 2-year history of hypertension and left flank pain after activity; his blood pressure fluctuated within 130–150/90–100 mmHg without treatment. He had microscopic hematuria (2+) and increased plasma renin activity. The findings of both color Doppler ultrasound and computed tomography angiography were consistent with a diagnosis of NCS. The patient had no history of familial hypertension or special medications. Secondary hypertension-related examinations showed no significant abnormalities. After placement of an endovascular stent in the left renal vein, normal blood flow resumed and the collateral circulation was reduced. Both the hypertension and flank pain were alleviated within 3 days after the intervention and did not reappear during the following 11 months. NCP/NCS accompanied by hypertension is very rare. The possibility of NCP/NCS should be considered when secondary hypertension cannot be explained by other factors. The mechanism by which hypertension is caused by NCP/NCS is rather complex and deserves further investigation.

V484: Laparoscopic Spleno-Renal Venous Bypass for Left Renal Vein Nutcracker Syndrome

2007 ◽  
Vol 177 (4S) ◽  
pp. 161-162
Author(s):  
Benjamin I. Chung ◽  
Monish Aron ◽  
Nicholas J. Hegarty ◽  
Inderbir S. Gill
Keyword(s):  
Renal Vein ◽  
Left Renal Vein ◽  
Nutcracker Syndrome ◽  
Venous Bypass

The desperate plea of women with the nutcracker syndrome

Phlebologie ◽  
2010 ◽  
Vol 39 (02) ◽  
pp. 104-111
Author(s):  
J. L. Villavicencio
Keyword(s):  
Renal Vein ◽  
Imaging Techniques ◽  
Left Renal Vein ◽  
Diagnostic Tools ◽  
Nutcracker Syndrome ◽  
Treatment Techniques ◽  
Children And Young Adults ◽  
Good Number ◽  
Pelvic Congestion

Summary Objective: To increase awareness on the severe impact of the nutcracker syndrome in women with undiagnosed disease. Patients and methods: We reviewed the medical literature and analyzed six representative series with 73 patients with nutcracker syndrome. Women with left flank pain, dyspareunia, dysuria, dysmenorrhea, micro- or macrohaematuria and pelvic congestion symptoms, should be carefully investigated for evidence of meso aortic left renal vein compression. A good number of our colleagues do not believe in the existence of the nutcracker syndrome and send these patients in a long pilgrimage in search of someone who can help them to get relief to their pain. New and improved imaging techniques can assist in the diagnosis but retrograde reno-gonadal phlebography and renocaval gradient are the most reliable diagnostic tools. Results: Among an assortment of treatment techniques, renal vein transposition and endovenous stenting were the two most commonly used procedures. There are no long term studies on renal vein stenting in children and young adults. Its use in these cases should be carefully considered. The nutcracker syndrome may present with pelvic congestion symptoms and its diagnosis missed. The patient's age, severity of symptoms and haemo dynamic renal studies should guide the treatment. Conclusion: An increased awareness of the existence of the nutcracker syndrome may prevent many unfortunate undiagnosed women from spending many months and often years of suffering.

Aspergillus Spondylodiscitis After Spinal Stenosis Surgery: A Case Report

2020 ◽  
Vol 5 (3 And 4) ◽  
pp. 155-160
Author(s):  
Mohsen Aghapoor ◽  
◽  
Babak Alijani Alijani ◽  
Mahsa Pakseresht-Mogharab ◽  
◽  
...  
Keyword(s):  
Antifungal Drugs ◽  
The Body ◽  
Lower Limbs ◽  
Lumbar Pain ◽  
Case Presentation ◽  
Delay In Diagnosis ◽  
Death Case ◽  
Therapeutic Results ◽  
History Of ◽  
Probable Diagnosis

Background and Importance: Spondylodiscitis is an inflammatory disease of the body of one or more vertebrae and intervertebral disc. The fungal etiology of this disease is rare, particularly in patients without immunodeficiency. Delay in diagnosis and treatment of this disease can lead to complications and even death. Case Presentation: A 63-year-old diabetic female patient, who had a history of spinal surgery and complaining radicular lumbar pain in both lower limbs with a probable diagnosis of spondylodiscitis, underwent partial L2 and complete L3 and L4 corpectomy and fusion. As a result of pathology from tissue biopsy specimen, Aspergillus fungi were observed. There was no evidence of immunodeficiency in the patient. The patient was treated with Itraconazole 100 mg twice a day for two months. Pain, neurological symptom, and laboratory tests improved. Conclusion: The debridement surgery coupled with antifungal drugs can lead to the best therapeutic results.

A Confrontation between Two Doctrines: The Birth of Struggle for Hegemony in Hebrew Children's Literature during the 1930s and 1940s

2008 ◽  
Vol 1 (2) ◽  
pp. 139-155 ◽  
Author(s):  
YAEL DARR
Keyword(s):  
Children's Literature ◽  
Educational System ◽  
Single Channel ◽  
Children’S Literature ◽  
The Political ◽  
Literary Creation ◽  
History Of ◽  
High Level ◽  
First Time ◽  
Literary Quality

This article describes a crucial and fundamental stage in the transformation of Hebrew children's literature, during the late 1930s and 1940s, from a single channel of expression to a multi-layered polyphony of models and voices. It claims that for the first time in the history of Hebrew children's literature there took place a doctrinal confrontation between two groups of taste-makers. The article outlines the pedagogical and ideological designs of traditionalist Zionist educators, and suggests how these were challenged by a group of prominent writers of adult poetry, members of the Modernist movement. These writers, it is argued, advocated autonomous literary creation, and insisted on a high level of literary quality. Their intervention not only dramatically changed the repertoire of Hebrew children's literature, but also the rules of literary discourse. The article suggests that, through the Modernists’ polemical efforts, Hebrew children's literature was able to free itself from its position as an apparatus controlled by the political-educational system and to become a dynamic and multi-layered field.

A New Step in the Study of the History of the Russian Prosecutor’s Office

2019 ◽  
pp. 94-98
Keyword(s):  
Russian Federation ◽  
Russian Empire ◽  
Practical Significance ◽  
History Of ◽  
The Russian Federation ◽  
The Russian Empire ◽  
High Level ◽  
The University

The paper is a review on the textbook by A. V. Yeremin, «The History of the National Prosecutor’s office» and the anthology «The Prosecutor’s Office of the Russian Empire in the Documents of 1722–1917» (authors: V. V. Lavrov, A. V. Eremin, edited by N. M. Ivanov) published at the St. Petersburg Law Institute (branch) of the University of the Prosecutor’s office of the Russian Federation in 2018. The reviewers emphasize the high relevance and high level of research, their theoretical and practical significance. The textbook and the anthology will help the students increase their legal awareness, expand their horizons.

“Ukrayinskyi Prapor” (1923—1932s): the Berlin period of the newspaper of the President of the Ukrainian National Council

2019 ◽  
pp. 13-33
Author(s):  
Nadiia Kulesha
Keyword(s):  
National Policy ◽  
Editorial Staff ◽  
National Council ◽  
Soviet Rule ◽  
Editorial Content ◽  
Paper Record ◽  
Science And Culture ◽  
History Of ◽  
High Level ◽  
Mainstream Press

The centenary of the Ukrainian Revolution (1917―1921s) made relevant the interest to the developments and the personalities of that time, specifically, to the personality of the President of the ZUNR, Petrushevych, Yevhen. The newspaper «Ukrayinskyi Prapor» founded in 1919 in Vienna, throughout its existence, was considered as an official print organ of the Dictator (i.e., Y. Petrushevych). The Vienna period of this publication lasted from August 1919 to mid-November 1923. From the end of November 1923 till April 1932, the paper was published in the capital of the Weimar Republic, Berlin. It was the only newspaper of the Ukrainian emigration published for the longest time in interwar Germany. It was an example of a socio-political periodical. There collaborated outstanding editors and publicists. The pages of this paper record the history of the diplomatic struggle of the West Ukrainian foreign representatives for the liberation of the Eastern Galicia from the protectorate of Poland and the restoration of Ukrainian statehood. Its materials documented the course of the occupation of the Eastern Galicia by Poland and the process of «Polonization» of the Ukrainian population of that region. The article explores the Berlin period of existence of the magazine. Specifically, it studies the changes in the ideological line of the magazine, more specifically, its pro-Soviet editorial orientation because of the illusions about the transformation of the national policy of the Soviet rule in Ukraine, especially during the period of Ukrainization. Then the traditional headings of the magazine were joined by the publications with positive coverage of the flourishing Ukrainianization in Soviet Ukraine. The newspaper also actively reacted to the SVU (Union for Liberation of Ukraine) trial in Kharkiv, justifying the position of the Soviet authorities. The paper’s editorial staff were well-known figures of Ukrainian politics, science, and culture: Yu. Bachynsky, O. Hrytsai, A. Zhuk, M. Lozynsky, R. Perfetsky, and others. They provided a high level of editorial content with high-quality, multifaceted texts. We conclude that in terms of the editorial content and formal aspects, the newspaper «Ukrayinskyi Prapor» matched the standards of the European mainstream press of that time.

Comparison of Non-radiographic Axial Spondyloarthritis and Ankylosing Spondyltis from a Single Rheumatology Hospital in Morocco

2020 ◽  
Vol 16 (3) ◽  
pp. 240-244 ◽  
Author(s):  
Nessrine Akasbi ◽  
Siar Nihad ◽  
Zoukal Sofia ◽  
El Kohen Khadija ◽  
Harzy Taoufik
Keyword(s):  
Disease Burden ◽  
Axial Spondyloarthritis ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Low Back ◽  
New Classification ◽  
Cross Sectional ◽  
Asas Criteria ◽  
History Of ◽  
High Level

Background: According to the new classification criteria developed by The Assessment of SpondyloArthritis International Society, patients with axial spondyloarthritis (axSpA) can be classified in 2 subgroups: Patients with radiographic axial spondyloarthritis: ankylosing spondylitis patients (AS) and those with non-radiographic axial spondyloarthritis (nr-axSpA). Objective: The aim of the present study is to describe and discuss the differences and similarities between the two subgroups. Patients and Methods: A cross-sectional study was conducted in a single rheumatology hospital in Morocco. These included patients diagnosed as having axial spondyloarthritis according to ASAS criteria 2010, during a period of 6 years. The AS and the nr-axSpA subgroups were compared for the various axSpA-related variables. Results: Of the 277 patients with a diagnosis of axial SpA who were included in this study, 160 had AS and 117 had nr-axSpA. AS and nr-ax-SpA shared a similar age at diagnosis, similar prevalence of low back pain, lumbar stiffness, extra-articular manifestations, BASDAI and BASFI. In the multivariate analysis, AS patients were mainly male with cervical stiffness, enthesitis, coxitis and high level of ESR (erythrocyte sedimentation rate). The females generally had a family history of SpA and arthritis and were associated to the nr-axSpA form in the univariate analysis. Conclusion: This was the first study to characterise patients with AS and nr-axSpA in Morocco. Consistent with other studies published, this study showed that patients with nr-axSpA and patients with AS shared a comparable degree of disease burden.

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