Renal vein stenting abates sickle cell trait mediated chronic refractory hematuria exacerbated by the Nutcracker phenomenon

Renal vein stenting abates sickle cell trait mediated chronic refractory hematuria exacerbated by the Nutcracker phenomenon

Nutcracker syndrome (NCS) is a rare vascular anomaly involving left renal vein (LRV) outflow entrapment most commonly between the aorta and the superiormesenteric artery (SMA). This can lead to chronic LRV hypertension with resultant gonadal vein reflux, pelvic varicosity formation, hematuria, anemi...

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Main Authors: Naiem Nassiri, Lauren A. Huntress, Sammy Elsamra, Susan Murphy, Yi-Horng Lee
Format: Article
Language:English
Published: Elsevier 2017-11-01
Series:Journal of Pediatric Surgery Case Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S2213576617301008
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spelling doaj-843b71dcc4e54f67bb0b938cef1e1fdd2020-11-24T22:08:33ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662017-11-0126C353810.1016/j.epsc.2017.08.015Renal vein stenting abates sickle cell trait mediated chronic refractory hematuria exacerbated by the Nutcracker phenomenonNaiem Nassiri0Lauren A. Huntress1Sammy Elsamra2Susan Murphy3Yi-Horng Lee4Yale University School of Medicine, Department of Surgery, Division of Vascular and Endovascular Surgery, New Haven, CT, United StatesRutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, United StatesRutgers-Robert Wood Johnson Medical School, Department of Surgery, Division of Urology, New Brunswick, NJ, United StatesRutgers-Robert Wood Johnson Medical School, Bristol-Meyers-Squibb Children's Hospital, The Cancer Institute of New Jersey, Department of Pediatrics, Division of Hematology & Oncology, New Brunswick, NJ, United StatesRutgers-Robert Wood Johnson Medical School, Department of Surgery, Division of Pediatric Surgery, New Brunswick, NJ, United StatesNutcracker syndrome (NCS) is a rare vascular anomaly involving left renal vein (LRV) outflow entrapment most commonly between the aorta and the superiormesenteric artery (SMA). This can lead to chronic LRV hypertension with resultant gonadal vein reflux, pelvic varicosity formation, hematuria, anemia, failure to thrive, and if severe enough, renal failure. Sickle cell trait (SCT) is a well-known and relatively common cause of hematuria causing damage to the renal microvasculature with subsequent renal papillary necrosis. In the rare setting of both conditions, LRV compression exacerbates upstream LRV sickling and exponentially augments hematuria. As is presented here, alleviation of LRV compression via a minimally endovascular approach can cease life-threatening hematuria.http://www.sciencedirect.com/science/article/pii/S2213576617301008
collection DOAJ
language English
format Article
sources DOAJ
author Naiem Nassiri
Lauren A. Huntress
Sammy Elsamra
Susan Murphy
Yi-Horng Lee
spellingShingle Naiem Nassiri
Lauren A. Huntress
Sammy Elsamra
Susan Murphy
Yi-Horng Lee
Renal vein stenting abates sickle cell trait mediated chronic refractory hematuria exacerbated by the Nutcracker phenomenon
Journal of Pediatric Surgery Case Reports
author_facet Naiem Nassiri
Lauren A. Huntress
Sammy Elsamra
Susan Murphy
Yi-Horng Lee
author_sort Naiem Nassiri
title Renal vein stenting abates sickle cell trait mediated chronic refractory hematuria exacerbated by the Nutcracker phenomenon
title_short Renal vein stenting abates sickle cell trait mediated chronic refractory hematuria exacerbated by the Nutcracker phenomenon
title_full Renal vein stenting abates sickle cell trait mediated chronic refractory hematuria exacerbated by the Nutcracker phenomenon
title_fullStr Renal vein stenting abates sickle cell trait mediated chronic refractory hematuria exacerbated by the Nutcracker phenomenon
title_full_unstemmed Renal vein stenting abates sickle cell trait mediated chronic refractory hematuria exacerbated by the Nutcracker phenomenon
title_sort renal vein stenting abates sickle cell trait mediated chronic refractory hematuria exacerbated by the nutcracker phenomenon
publisher Elsevier
series Journal of Pediatric Surgery Case Reports
issn 2213-5766
publishDate 2017-11-01
description Nutcracker syndrome (NCS) is a rare vascular anomaly involving left renal vein (LRV) outflow entrapment most commonly between the aorta and the superiormesenteric artery (SMA). This can lead to chronic LRV hypertension with resultant gonadal vein reflux, pelvic varicosity formation, hematuria, anemia, failure to thrive, and if severe enough, renal failure. Sickle cell trait (SCT) is a well-known and relatively common cause of hematuria causing damage to the renal microvasculature with subsequent renal papillary necrosis. In the rare setting of both conditions, LRV compression exacerbates upstream LRV sickling and exponentially augments hematuria. As is presented here, alleviation of LRV compression via a minimally endovascular approach can cease life-threatening hematuria.
url http://www.sciencedirect.com/science/article/pii/S2213576617301008
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AT susanmurphy renalveinstentingabatessicklecelltraitmediatedchronicrefractoryhematuriaexacerbatedbythenutcrackerphenomenon
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