Loin Pain/Hematuria Syndrome
- 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.
- Range: 10 to 70 years
- 70% of cases are in females.
- More common in white female in 20s to 30s
Etiology and Pathophysiology
- 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.
No report of genetic involvement
Commonly Associated Conditions
- Somatoform disorder
- 50% of patients have a history of nephrolithiasis.
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Domino, Frank J., et al., editors. "Loin Pain/Hematuria Syndrome." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. 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; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816807/all/Loin_Pain_Hematuria_Syndrome. Accessed June 5, 2023.
Loin Pain/Hematuria Syndrome. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th 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; 2020. [cited 2023 June 05]. 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 - 27 DB - Medicine Central DP - Unbound Medicine ER -