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Loin Pain/Hematuria Syndrome

Kantima Phisitkul, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • A rare and poorly understood syndrome characterized by unexplained chronic, severe, intermittent or persistent, unilateral or bilateral loin/flank pain with microscopic or gross hema...

DIAGNOSIS

HISTORY

  • Chronic flank pain (>6 months) typically described as burning or throbbing that is severe, unilateral or bilateral, persistent, or recurrent. The duration is variable and may persi...

TREATMENT

GENERAL MEASURES

  • Focused on pain control

  • Most recommendations are based on observational studies, small case series, and anecdotal reports.

  • A multidisciplinary approach partnering medical manag...

ONGOING CARE

DIET

No restrictions 

PATIENT EDUCATION

  • It is a chronic pain syndrome with medical and psychological aspects.

  • Nephrectomy should be considered as a last resort.

PROGNOSIS

  • 1/3 of patients have a...

REFERENCES

1
Taba Taba Vakili S, Alam T, Sollinger H. Loin pain hematuria syndrome. Am J Kidney Dis.  2014;64(3):460–472. [View Abstract on OvidMedline]
2
Smith HS, Bajwa ZH. Loin pain hematuria syn...

ADDITIONAL READING

Dube GK, Hamilton SE, Ratner LE, et al. Loin pain hematuria syndrome. Kidney Int.  2006;70(12):2152–2155. [View Abstract on OvidMedline] 

CODES

ICD10

  • R10.9 Unspecified abdominal pain

  • R31.9 Hematuria, unspecified

  • R31.2 Other microscopic hematuria

  • R31.0 Gross hematuria

ICD9

  • 789.09 Abdominal pain, other specified site

  • 599.70 Hematuria, unspecifie...

CLINICAL PEARLS

  • Loin pain/hematuria syndrome is a controversial disease with uncertain cause and pathophysiology.

  • It’s likely a common presentation of different pathologic entities.

  • All standard labs an...

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