The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

A Case of Nutcracker Syndrome Combined with IdiopathicMembranoproliferative Glomerulonephritis, Type I

Nutcracker Syndrome과 함께 진단된 특발성 막증식성 사구체 신염 제1형 1예

  • Shin, Min-Ji (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Lee, Hee-Sun (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • An, Kang-Hee (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Hwang, Jong-Min (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Nam, Hyung-Suk (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Jung-Sup (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kwak, Ihm-Soo (Department of Internal Medicine, Pusan National University School of Medicine)
  • 신민지 (부산대학교 의학전문대학원 내과학교실) ;
  • 이희선 (부산대학교 의학전문대학원 내과학교실) ;
  • 안강희 (부산대학교 의학전문대학원 내과학교실) ;
  • 황종민 (부산대학교 의학전문대학원 내과학교실) ;
  • 남형석 (부산대학교 의학전문대학원 내과학교실) ;
  • 김정섭 (부산대학교 의학전문대학원 내과학교실) ;
  • 곽임수 (부산대학교 의학전문대학원 내과학교실)
  • Published : 2011.07.01
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Abstract

The Nutcracker syndrome refers to compression of the left renal vein between the aorta and superior mesenteric artery, which results in renal vein and left gonadal vein varices, hematuria, and left flank pain. Here, we report a case of biopsy-proven membranoproliferative glomerulonephritis with radiologically documented Nutcracker syndrome. The patient presented with generalized edema for several months. In order to evaluate isomorphic hematuria, we performed computed tomography (CT), which showed Nutcracker syndrome. A renal biopsy revealedmembranoproliferative glomerulonephritis, Type I. In conclusion, inadults with Nutcracker syndrome that involves severe proteinuria, the possibility of combined glomerulonephritis must be considered.

Nutcracker 증후군이란 좌측 신정맥이 대동맥과 상장간막동맥 사이에서 압박을 받아 발생하는 임상적인 증후군으로 무증상의 혈뇨, 좌측 요통이나 복통의 형태로 나타나고 심한 단백뇨는 드물다고 알려져 있다. 저자들은 신증후군과 현미경적 혈뇨로 내원하여 Nutcracker syndrome과 함께 특발성 막증식성 사구체신염 제1형으로 확진된 1예를 경험하였다. Nutcracker 증후군으로 진단되더라도 심한 단백뇨를 보일 때는 사구체신염의 동반 가능성도 배제해야 하므로 신생검을 고려해야 하겠다.

Keywords

References

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