A 14-year-old girl with recumbent proteinuria.
We describe a 14-year-old female who presented with persistently elevated nighttime urinary protein excretion without additional clinical symptoms. She had no evidence of intrinsic renal disease on physical examination or laboratory studies. Ultrasound examination of the abdomen revealed a large cyst arising from the spleen. CT scan showed compression of the left renal vein by the splenic cyst. Removal of the cyst resulted in resolution of her proteinuria. Entrapment of the left renal vein (nutcracker syndrome) remains a rare but important cause of elevated protein excretion.
Faizan
M Khurram
MK
Division of Nephrology, CH-46, Children's Hospital and Regional Medical Center, 4800 Sand Point Way NE, Seattle, WA 98105-0371, USA. kfaiza@chmc.org
Finn
Laura S
LS
Paladin
Angelisa M
AM
McDonald
Ruth A
RA
D000293:Adolescent; D002940:Circadian Rhythm; D003560:Cysts / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D011507:Proteinuria / Q000209:etiology* / Q000503:physiopathology*; D012082:Renal Veins / Q000000981:diagnostic imaging; D013158:Splenic Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology