A rare case of nutcracker phenomenon with nephrotic syndrome
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We report a 40-year-old woman who developed persistently nephrotic range proteinuria resulting from the nutcracker phenomenon. The 40-year-old female who was complaining of lower extremity edema for about 2 weeks had exercised a lot in the past 2 months. She denied any gross hematuria, urinary tract infections, joint pain and rashes. She denied any hepatitis, infectious medical histories and hypertension.
On physical examination, the patient’s weight was 60 kg, height was 173 cm, and BMI was 20.8 kg/m2. The rest of her physical examination was remarkable for lower extremity edema. After admission, the laboratory analysis revealed: urinalysis protein 4+, RBCs: 0/HP, serum creatinine: 6.4 mg/dl (57 μmol/l), BUN: 5.94 mg/dl (2.38 mmol/l), eGFR by MDRD: 107.3 ml/min/1.73 m2. Two 24-h urine collections showed protein of 3992 mg and 4363 mg, respectively, serum albumin 19.7 g/l, total cholesterol 402 mg/dl (10.30 mmol/l), low-density lipoprotein cholesterol (LDL-C) 251 mg/dl...
KeywordsProteinuria Nephrotic Syndrome Superior Mesenteric Artery Left Renal Vein Microscopic Hematuria
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Conflict of interest
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study. The patient has given written consent to publish her personal and medical information for the publication of the case report.