Kidney Function

Loin pain and hematuria are common symptoms, presenting in patients of all ages. There are various underlying pathologic causes, including renal or ureteric calculi or tumors, intrinsic kidney disease (including glomerulonephritis), and loin pain hematuria syndrome. Since some of these causes are potentially serious and may be treatable if identified early, it is important to establish a diagnosis. Patients therefore often undergo multiple investigations and procedures. However, in some cases, no cause is identified unless rarer pathologic states are considered. We describe a patient with loin pain and hematuria who proved to be a diagnostic dilemma for several years before the diagnosis of nutcracker syndrome was established.