Endoscopic Findings in Loin Pain Hematuria Syndrome: Concentric Clot in Calyceal Fornices

The loin pain hematuria syndrome (LPHS) creates a considerable burden, both for patients afflicted with the disease and for those involved in medical management and diagnosis. To date, the diagnosis of LPHS remains one of exclusion, with some speculation regarding the extent of actual pathology. We report ureteroscopic findings in 2 cases of LPHS. These findings provide objective confirmation of underlying pathology in a difficult-to-manage disease process.

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Pain Management Techniques for Loin Pain Hematuria Syndrome Case Report

Pain Management Case Reports ◽

10.36076/pmcr.2020/4/141 ◽

2020 ◽

pp. 141-144

Author(s):

Sarang Koushik

Keyword(s):

Spinal Cord ◽

Case Report ◽

Spinal Cord Stimulation ◽

Renal Denervation ◽

Treatment Options ◽

Disease Process ◽

Current Treatment ◽

Flank Pain ◽

Loin Pain ◽

Loin Pain Hematuria Syndrome

Background: Loin pain hematuria syndrome (LPHS) is a rare syndrome presenting with chronic unilateral or bilateral flank pain and gross or microscopic hematuria. Case Report: We present a case of LPHS in a male with past medical history of atrial fibrillation, Barrett’s esophagus, and loin pain hematuria syndrome who initially presented to our medical facility with gross hematuria, intractable left flank pain, and non-bloody emesis. Our case exemplifies the challenge in managing patients with LPHS. Conclusion: Without a definitive mechanism for LPHS, current treatment focuses on symptom management. Analgesics (non-opioid and opioid) may be used orally or intravenous depending on the presence of concomitant nausea and vomiting. For patients at risk of opioid dependence, targeting afferent pain fibers originating from the kidneys and ureters has proven a successful analgesic strategy. Surgical options for renal denervation include: endovascular radiofrequency ablation, laparoscopic renal denervation, and renal auto transplant. Treatment options for this disease process include intra-ureteric bupivacaine, renal denervation, and possible spinal cord stimulation. Key words: Flank pain, loin pain hematuria syndrome, renal denervation, spinal cord stimulation

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Drug-Induced Movement Disorders

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld25.2.70 ◽

2015 ◽

Vol 25 (2) ◽

pp. 70-77

Author(s):

Amy Lustig ◽

Cesar Ruiz

Keyword(s):

Movement Disorders ◽

Medical Management ◽

Disease Process ◽

Underlying Disease ◽

Extrapyramidal Symptoms ◽

Drug Induced ◽

General Overview ◽

Management Approaches ◽

Broad Understanding ◽

Underlying Disease Process

The purpose of this article is to present a general overview of the features of drug-induced movement disorders (DIMDs) comprised by Parkinsonism and extrapyramidal symptoms. Speech-language pathologists (SLPs) who work with patients presenting with these issues must have a broad understanding of the underlying disease process. This article will provide a brief introduction to the neuropathophysiology of DIMDs, a discussion of the associated symptomatology, the pharmacology implicated in causing DIMDs, and the medical management approaches currently in use.

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Treatment and Management of Loin Pain Hematuria Syndrome

Current Pain and Headache Reports ◽

10.1007/s11916-020-00925-0 ◽

2021 ◽

Vol 25 (1) ◽

Author(s):

Ivan Urits ◽

Nathan Li ◽

Amnon A. Berger ◽

Paul Walker ◽

Brendan Wesp ◽

...

Keyword(s):

Loin Pain ◽

Loin Pain Hematuria Syndrome

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Non-bacterial thrombotic endocarditis

ESC CardioMed ◽

10.1093/med/9780198784906.003.0395 ◽

2018 ◽

pp. 1728-1729

Author(s):

Patrizio Lancellotti ◽

Stella Marchetta

Keyword(s):

Disease Process ◽

Blood Cultures ◽

Clinical Suspicion ◽

Heart Murmur ◽

Tailored Approach ◽

Platelet Aggregates ◽

Diagnostic Work ◽

Work Up ◽

Underlying Pathology ◽

Diagnostic Work Up

Non-bacterial thrombotic endocarditis (NBTE) is characterized by the presence of sterile vegetations on cardiac valves that consist of fibrin and platelet aggregates. These vegetations are neither associated with bacteraemia nor with destructive changes of the underlying valve. The diagnosis of NBTE relies on strong clinical suspicion in the context of (a) a disease process known to be associated with NBTE, (b) the presence of a heart murmur, (c) a negative blood culture, (d) the presence of vegetations not responding to antibiotic treatment, and (e) evidence of multiple systemic emboli. The same initial diagnostic work-up as for infective endocarditis is recommended. Serial blood cultures, exhaustive haematological and coagulation studies, and a comprehensive echocardiography should be performed. The management of NBTE is challenging and a tailored approach should be advocated. It should first focus on the underlying pathology. In the absence of contraindications, an anticoagulation treatment should be given. Surgical intervention is not recommended unless the patient has clear indications (i.e. heart failure due to valve dysfunction).

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Renal hilar block predicts long-term success of renal auto-transplantation for loin pain hematuria syndrome

International Urology and Nephrology ◽

10.1007/s11255-019-02143-z ◽

2019 ◽

Vol 51 (6) ◽

pp. 927-930

Author(s):

Jeffrey Campsen ◽

Mitchell R. Bassett ◽

Ryan O’Hara ◽

Robin D. Kim ◽

Eryberto Martinez ◽

...

Keyword(s):

Loin Pain ◽

Loin Pain Hematuria Syndrome

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Demyelination of Vestibular Nerve Axons in Unilateral Ménière's Disease

Ear Nose & Throat Journal ◽

10.1177/014556130208101113 ◽

2002 ◽

Vol 81 (11) ◽

pp. 785-789 ◽

Cited By ~ 2

Author(s):

Robert F. Spencer ◽

Aristides Sismanis ◽

Jefferson K. Kilpatrick ◽

Wayne T. Shaia

Keyword(s):

Medical Management ◽

Light And Electron Microscopy ◽

Disease Process ◽

Meniere’S Disease ◽

Vestibular Nerve ◽

Menière’S Disease ◽

Meniere's Disease ◽

Ménière’S Disease ◽

Menière's Disease ◽

Ménière's Disease

We conducted a study to determine whether vestibular nerves inpatients with unilateral Ménière's disease whose symptoms are refractory to medical management exhibit neuropathologic changes. We also endeavored to determine whether retrocochlear abnormalities are primary or secondary factors in the disease process. To these ends, we obtained vestibular nerve segments from five patients during retrosigmoid (posteriorfossa) neurectomy, immediately fixed them, and processed them for light and electron microscopy. We found that all five segments exhibited moderate to severe demyelination with axonal sparing. Moreover, we noted that reactive astrocytes produced an extensive proliferation of fibrous processes and that the microglia assumed a phagocytic role. We conclude that the possible etiologies of demyelination include viral and/or immune-mediated factors similar to those seen in other demyelinating diseases, such as multiple sclerosis and Guillain-Barré syndrome. Our findings suggest that some forms of Ménière's disease that are refractory to traditional medical management might be the result of retrocochlear pathology that affects the neuroglial portion of the vestibular nerve.

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