Loin pain hematuria syndrome

Abstract

Loin pain hematuria syndrome (LPHS), first described in 1967, is a rare pain syndrome, which is not well understood. The syndrome is characterized by severe intermittent or persistent flank pain, either unilateral or bilateral, associated with gross or microscopic hematuria. LPHS is a diagnosis of exclusion as there still is not a consensus of validated diagnostic criteria, though several criteria have been proposed. The wide differential diagnosis would suggest a meticulous yet specific diagnostic work-up depending on the individual clinical features and natural history. Several mechanisms regarding the pathophysiology of LPHS have been proposed but without pinpointing the actual causative etiology, the treatment remains symptomatic. Treatment modalities for LPHS are diverse including simple analgesia, opioid analgesic and kidney autotransplantation. This review article summarizes the current understanding regarding the pathophysiology of LPHS along with the steps required for proper diagnosis and a discussion of the different therapeutic approaches for LPHS.

Dorsal Root Ganglion Stimulation: A Treatment Option for Chronic Pain Due to Refractory Loin Pain Haematuria Syndrome

“…Smith et al and Zubair et al summarize treatment options for LPHS, respectively in Clinical Journal of Pain (2012) and Clinical Kidney Journal (2016). Conventional treatment for LPHS consists of physiotherapeutic and psychological treatments and neuropathic analgesics (e.g., tricyclic antidepressants, antiepileptics) and opioids.…”

Comprehensive First‐Line Magnetic Resonance Imaging in Hypertension: Experience From a Single‐Center Tertiary Referral Clinic

“…Fifteen of 21 findings likely incidental: Nine unilateral or bilateral simple cyst(s) Four anatomical variants not felt to cause hypertension (eg, horseshoe kidney and duplex malrotated kidney) One patient with pelvicalyceal dilatation and possible renal parenchymal abnormality, further defined on CT and reported to be benign One previous nephrectomy for loin pain hematuria syndrome Not known to cause hypertension; referral for renal denervation to treat concurrent resistant hypertension and, potentially, loin pain …”

Renal impairment and analgesia: From effectiveness to adverse effects

“…Intraureteric bupivacaine also provides a long‐term potential for the analgesic treatment of LPHS (Ahmed, Acher, & Deane, ), whereas an intrarenal administration of capsaicin was seen to have transitory effectiveness in addition to complications (Uzoh, Kumar, & Timoney, ). However, surgical methods are mostly found to be curative in this case (Zubair, Salameh, Erickson, & Prieto, ).…”