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Nephroptosis in a young woman with joint laxity

Nature Reviews Nephrology volume 5, pages 722–725 (2009)Cite this article

Abstract

Background. A 25-year-old woman was evaluated repeatedly from 10 months following her first pregnancy and delivery for recurrent episodes of lower right quadrant abdominal pain, hematuria and a sensation of mass. Despite investigations by several physicians over a 7 month period no clear diagnosis had been made, but a psychosomatic disorder or possible periodic blocked bowel had been suggested, after which the patient requested a consultation with a nephrologist. Her history indicated joint laxity syndrome and a mitral valve prolapse. She was undergoing continuing evaluation for a possible rheumatic condition.

Investigations. Full history, physical examination, and intravenous pyelography.

Diagnosis. Nephroptosis of the right kidney.

Intervention. Exercises were prescribed to strengthen her abdominal musculature and she was advised to wear an elastic abdominal corset during the daytime. The patient is currently considering surgical intervention.

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Figure 1: Intravenous pyelography in the a | supine and b | upright positions.

References

  1. Young, H. H. & Davis, D. M. Young's Practice of Urology. Vol. 2. Malformation and abnormalities of the urogenital tract. 1–36 (WB Saunders, Philadelphia, 1926).

    Google Scholar 

  2. Barber, N. J. & Thompson, P. M. Nephroptosis and nephropexy—hung up on the past? Eur. Urol. 46, 428–433 (2004).

    Article  CAS  PubMed  Google Scholar 

  3. Moss, S. W. Floating kidneys: a century of nephroptosis and nephropexy. J. Urol. 158 (3 Pt 1), 699–702 (1997).

    CAS  PubMed  Google Scholar 

  4. Srirangam, S. J., Pollard, A. J., Adeyoju, A. A. B. & O'Reilly, P. H. Nephroptosis: seriously misunderstood? BJU Int. 103, 296–300 (2009).

    Article  PubMed  Google Scholar 

  5. Wilcox, D. G. A case of nephrorraphy for fixation of a floating kidney. Ann. Surg. 7, 192–194 (1888).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Strohmeyer, D. M. et al. Changes in renal blood flow in nephroptosis: assessment by color Doppler imaging, isotope renography and corrrelation with clinical outcome after laparoscoopic nephropexy. Eur. Urol. 45, 790–793 (2004).

    Article  PubMed  Google Scholar 

  7. Clorius, J. H., Kjelle-Schweigler, M., Georgi, P., Sinn, H. J. & Moehring, K. Position dependent renogram changes of the mobile kidney. Eur. J. Nucl. Med. 2, 67–70 (1977).

    Article  CAS  PubMed  Google Scholar 

  8. Sheon, R. P. Clinical manifestations and treatment of the hypermobility syndrome. UpToDate [online], (2009).

    Google Scholar 

  9. O'Reilly, P. H. & Pollard, A. J. Nephroptosis: a cause of renal pain and a potential cause of inaccurate split renal function determination. Br. J. Urol. 61, 284–288 (1988).

    Article  CAS  PubMed  Google Scholar 

  10. Arnerlöv, C, Petersen, E., Söderström, M. & Ohberg, L. Dynamic sonography with provocation of pain for diagnosis of symptomatic mobile kidneys. Eur. J. Surg. 167, 218–221 (2001).

    Article  PubMed  Google Scholar 

  11. Mathe, C. P. The present-day status of nephropexy and end results in 384 operative cases. Urol. Cutan. Rev. 41, 772 (1937).

    Google Scholar 

  12. Matsui, Y. et al. Laparoscopic nephropexy: treatment outcome and quality of life. Int. J. Urol. 11, 1–6 (2004).

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Allegheny General Hospital, Pittsburgh, PA, USA

    Barbara A. Clark

  2. Kaiser Foundation Hospital, Fresno, CA, USA

    Amandeep Sekhon

Authors
  1. Barbara A. Clark
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  2. Amandeep Sekhon
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Correspondence to Barbara A. Clark.

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The authors declare no competing financial interests.

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Clark, B., Sekhon, A. Nephroptosis in a young woman with joint laxity. Nat Rev Nephrol 5, 722–725 (2009). https://doi.org/10.1038/nrneph.2009.169

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  • DOI: https://doi.org/10.1038/nrneph.2009.169

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