СИНДРОМ ЩЕЛКУНЧИКА В ПРАКТИКЕ ДЕТСКОГО НЕФРОЛОГА

Natalia E Prokopyeva; Olga V Kozlovskaya; Svetlana A Lopatina; Lyubov V Kiryukhina; Mikhail V Erman; Tatyana V Kolesova; Vladimir G Kritsuk

Natalia E Prokopyeva Children’s City Hospital No. 2 of St. Mary Magdalene; Saint-Petersburg State Pediatric Medical University 199004, Saint-Рetersburg; 194100, Saint-Рetersburg
Olga V Kozlovskaya Children’s City Hospital No. 2 of St. Mary Magdalene 199004, Saint-Рetersburg
Svetlana A Lopatina Children’s City Hospital No. 2 of St. Mary Magdalene 199004, Saint-Рetersburg
Lyubov V Kiryukhina Children’s City Hospital No. 2 of St. Mary Magdalene 199004, Saint-Рetersburg
Mikhail V Erman Children’s City Hospital No. 2 of St. Mary Magdalene 199004, Saint-Рetersburg
Tatyana V Kolesova Children’s City Hospital No. 2 of St. Mary Magdalene 199004, Saint-Рetersburg
Vladimir G Kritsuk Children’s City Hospital No. 2 of St. Mary Magdalene 199004, Saint-Рetersburg

Keywords: Nutcracker syndrome, impaired renal vein, hematuria, orthostatic proteinuria, left renal vein hypertension

Abstract

Nutcracker syndrome (NCS) - characterized by compression of the left renal vein (LRV), most commonly between the aorta (Ao) and superior mesenteric artery (SMA). The nutcracker syndrome describes patients with characteristic symptoms associated with the anatomical morphology of the nutcracker, while the nutcracker phenomenon describes the aorto mesenteric compression of the LRV in asymptomatic course. Symptoms include hematuria, orthostatic proteinuria, flank pain, abdominal pain, varicocele, dyspareunia, and dysmenorrhea. The presence of clinical signs is the basis for the diagnosis. Several imaging techniques such as Doppler ultrasound, computed tomography angiography, magnetic resonance angiography, and retrograde venography are used to diagnose NCS. The management of NCS depends on the clinical presentation and severity of LRV hypertension. Treatment decisions should be based on the severity of the symptoms and their expected reversibility, taking into account the patient’s age and the stage of the syndrome.

Author Biographies

Natalia E Prokopyeva, Children’s City Hospital No. 2 of St. Mary Magdalene; Saint-Petersburg State Pediatric Medical University 199004, Saint-Рetersburg; 194100, Saint-Рetersburg

Vasilievsky Island, 1st line, 58; Litovskaya str., 2; research assistant at the Laboratory of Medical and Social Problems in Pediatrics at the Research Center

Olga V Kozlovskaya, Children’s City Hospital No. 2 of St. Mary Magdalene 199004, Saint-Рetersburg