Causes
Rarely, loin pain hematuria syndrome (LPHS) is characterized by severe loin (flank) pain and hematuria (blood in the urine) without a known cause. In theory, LPHS is caused by abnormalities in the blood vessels or nerves surrounding the kidneys, but the exact cause has not been determined.
Symptoms
LPHS symptoms include:
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An intense, recurrent pain in one or both flanks that usually lasts for hours to days.
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Blood in the urine, which can be seen with the naked eye or detected through urine tests.
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During episodes of loin pain, some individuals experience nausea, vomiting, or fever.
Diagnosis
It can be challenging to diagnose LPHS, and it often involves ruling out other possible causes of pain and hematuria. Diagnostic tests may include:
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Analyzing urine samples to detect blood and rule out other urinary tract problems.
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The kidneys and surrounding structures can be evaluated by imaging tests such as ultrasound, CT scan, or MRI.
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A kidney biopsy may be needed in some cases to rule out other kidney diseases.
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Prior to confirming the diagnosis of LPHS, other possible causes of loin pain and hematuria must be excluded.
Treatment
LPHS is treated by managing symptoms and may include:
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For severe pain during episodes, nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids may be prescribed.
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Controlling high blood pressure may help alleviate symptoms if it is present.
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To temporarily alleviate pain, nerve block procedures may be beneficial to some individuals.
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In severe cases, procedures such as renal denervation or sympathectomy may be considered to disrupt nerve signals and reduce pain.
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In managing chronic pain associated with LPHS, cognitive-behavioral therapy or other forms of psychotherapy may be helpful.
Prevention
LPHS is difficult to prevent due to poorly understood underlying causes, however certain lifestyle modifications may help manage symptoms and reduce the frequency of episodes, including:
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A healthy lifestyle may help reduce the severity of symptoms by maintaining a healthy diet, staying hydrated, and managing stress levels.
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LPHS patients should have regular follow-up appointments with healthcare providers to monitor symptoms and adjust treatment accordingly.
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Preventing episodes of loin pain by identifying and avoiding triggers, such as certain foods or activities that may exacerbate symptoms.
Conclusion
A rare condition characterized by severe loin pain and hematuria without a known cause, loin pain hematuria syndrome is difficult to diagnose and must be ruled out from other causes of severe pain and hematuria. In addition to pain management, blood pressure control, and interventional therapies, treatment includes managing symptoms. Prevention strategies are limited, but may include lifestyle modifications and avoiding triggers that exacerbate the condition.
