Loin Pain/Hematuria Syndrome
Basics
Description
- A rare and poorly understood syndrome characterized by unexplained chronic, severe, intermittent or persistent, unilateral or bilateral loin/flank pain with microscopic or gross hematuria
- It is a diagnosis of exclusion.
- Treatment focuses on pain management which requires reassurance, careful management of analgesia, and psychological support.
Epidemiology
Incidence
Unknown
Prevalence
- 0.01%
- Range: 10 to 70 years
- 70% of cases are in females.
- More common in white female in 20s to 30s
Etiology and Pathophysiology
- Uncertain
- Several hypotheses have been proposed such as microvascular abnormalities, complement activation on arterioles, renal vasospasm, veno-caliceal fistula, abnormal ureteral peristalsis, intratubular crystal formation, abnormal platelet function, or psychogenic nature.
- Glomerular basement membrane abnormalities (too thick or thin) leading to glomerular wall rupture and passage of red blood cell (RBC) into the urinary space, causing tubular obstruction and back leak of glomerular filtrate with resultant parenchymal edema and stretching of renal capsule have been proposed.
Genetics
No report of genetic involvement
Risk Factors
Unknown
General Prevention
N/A
Commonly Associated Conditions
- Somatoform disorder
- 50% of patients have a history of nephrolithiasis.
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Citation
Domino, Frank J., et al., editors. "Loin Pain/Hematuria Syndrome." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816807/all/Loin_Pain_Hematuria_Syndrome.
Loin Pain/Hematuria Syndrome. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816807/all/Loin_Pain_Hematuria_Syndrome. Accessed October 15, 2024.
Loin Pain/Hematuria Syndrome. (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816807/all/Loin_Pain_Hematuria_Syndrome
Loin Pain/Hematuria Syndrome [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 October 15]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816807/all/Loin_Pain_Hematuria_Syndrome.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Loin Pain/Hematuria Syndrome
ID - 816807
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816807/all/Loin_Pain_Hematuria_Syndrome
PB - Wolters Kluwer
ET - 33
DB - Medicine Central
DP - Unbound Medicine
ER -