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Significant Proteinuria Caused by Posterior Nutcracker Phenomenon

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주제분류소아과학

초록

Posterior nutcracker phenomenon (PNP) was found to be the cause of significant proteinuria in a 10-year-old female. PNP was documented by Doppler ultrasonography and abdominal 3D CT as a cause of her proteinuria. Despite treatment with ACE inhibitor for several months, her persistent and progressive proteinuria lead us to perform a left renal biopsy, which revealed no significant finding except for focal effacement of foot processes. We speculate that nutcracker phenomenon can induce not only orthostatic proteinuria but also significant proteinuria by focal effacement of foot processes.

Abstract

Posterior nutcracker phenomenon (PNP) was found to be the cause of significant proteinuria in a 10-year-old female. PNP was documented by Doppler ultrasonography and abdominal 3D CT as a cause of her proteinuria. Despite treatment with ACE inhibitor for several months, her persistent and progressive proteinuria lead us to perform a left renal biopsy, which revealed no significant finding except for focal effacement of foot processes. We speculate that nutcracker phenomenon can induce not only orthostatic proteinuria but also significant proteinuria by focal effacement of foot processes.

참고문헌 (6)

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  2. Kim SH, "Nutcracker syndrome: diagnosis with Doppler US", Radiology, 198, pp.93~97 (1996)
  3. Mesiha E, "Osthostatic proteinuria as a result of venous compression (nutcracker phenomenon)-a hypothesis testable with modern imaging techniques", Nephrol Dial Transplant, 14, pp.826~827 (1999)
  4. Karaman B, "Retroaortic left renal vein: multidetector computed tomography angiography findings and its clinical importance", Acta Radiol, 48, pp.355~360 (2007)
  5. Ho J, "Podocyte-specific loss of functional microRNAs leads to rapid glomerular and tubular injury", J Am Soc Nephrol, 19, pp.2069~2075 (2008)
  6. Zhang H, "The left renal entrapment syndrome: diagnosis and treatment", Ann Vasc Surg, 21, pp.198~203 (2007)

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