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Loin pain hematuria syndrome


Other Names for this Disease

  • LPHS
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.

Overview

What is loin pain-hematuria syndrome?

What are the signs and symptoms of loin pain-hematuria syndrome?


What causes loin pain-hematuria syndrome?

How is loin pain-hematuria syndrome diagnosed?

How might loin pain-hematuria syndrome be treated?

What is the typical prognosis for people with loin pain hematuria syndrome?

What is loin pain-hematuria syndrome?

Loin pain-hematuria syndrome (LPHS) is a kidney disorder characterized by persistent or recurrent loin pain and hematuria (blood in the urine). The hematuria is usually microscopic, however most people with LPHS also experience at least one episode of gross (visible) hematuria. LPHS is considered primary when it occurs alone and secondary when it occurs with an acquired glomerular disease (for example IgA nephropathy).[1]
Last updated: 10/7/2013

What are the signs and symptoms of loin pain-hematuria syndrome?

Most people with loin pain-hematuria syndrome (LPHS) have both loin pain and hematuria, but some have only one of these symptoms. The loin pain is sometimes described as burning or throbbing. The pain may be present in one or both sides of the body, and it can be made worse by movement or exercise. Pain episodes may last from hours to months and can be accompanied by painful urination, low-grade fever, and/or nausea. People with LPHS may experience gross hematuria (visible blood in the urine). This is almost always associated with worsening pain. Up to half of people with LPHS also have kidney stones.[1]
Last updated: 10/7/2013

What causes loin pain-hematuria syndrome?

Currently, the cause of loin pain-hematuria syndrome (LPHS) is unknown. Researchers have hypothesized that the syndrome may be due to blood vessel diseases of the kidney, spasms of the kidney vessels, or other bleeding disorders (coagulopathy).[1]

The hematuria in LPHS may be due to an abnormal (thick or thin) glomerular basement membrane. The glomerular basement membrane is a tissue in the kidney that filters the blood. An abnormal glomerular basement membrane may allow red blood cells into the urinary space.[1]

Because kidney stones are so common in people with LPHS, crystals in the kidney tubules may also play a part in bleeding and pain.[1]

Last updated: 10/7/2013

How is loin pain-hematuria syndrome diagnosed?

Diagnosis of loin pain-hematuria syndrome (LPHS) occurs when hematuria is present, recurrent or persistent pain is severe, and other causes of bleeding are excluded.

Urine testing can be performed to detect microscopic levels of hematuria. Protein is also commonly found in the urine of patients with LPHS. Kidney biopsies are sometimes performed to look for evidence of glomerular hematuria, excess red blood cells in the kidney tubules, and to assess the width of the glomerular basement membrane.[1]

Last updated: 10/7/2013

How might loin pain-hematuria syndrome be treated?

Treatment of loin pain-hematuria syndrome (LPHS) typically consists of pain management. Narcotics or oral opioids may be prescribed to help control pain. Patients with severe pain may need high-dose opioids daily or almost daily. Occasionally, people with LPHS require hospitalization for intravenous opioid therapy and control of nausea.[1]

Other treatments may include denervation, autotransplantation, renal neurectomy, or nephrectomy. Unfortunately symptoms often recur following these procedures. Limited evidence suggests that drugs that inhibit angiotensin may reduce the frequency and severity of episodes of loin pain and gross hematuria.[1]

Last updated: 10/7/2013

What is the typical prognosis for people with loin pain hematuria syndrome?

Prognostic data on loin pain hematuria syndrome (LPHS) is lacking. However, it appears in many cases that LPHS resolves with time. LPHS does not cause kidney failure and it is not associated with a shortened life expectancy.[1]
Last updated: 10/7/2013

References
  1. Hebert, LA. Loin pain-hematuria syndrome. In: Forman, JP (Ed). UpToDate. Waltham, MA: UpToDate; 2012;


Other Names for this Disease
  • LPHS
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.