ACE inhibition can improve orthostatic proteinuria associated with nutcracker syndrome.
Left renal vein entrapment syndrome (nutcracker syndrome) was documented by magnetic resonance angiography (MRA) as a cause of orthostatic proteinuria in a 14-year-old girl female adolescent. Because of continuous proteinuria we performed a left renal biopsy which showed moderate mesangial hypercellularity. Her overt orthostatic proteinuria disappeared after a treatment of angiotensin-converting enzyme (ACE) inhibition. Nutcracker syndrome remains a rare but important cause of elevated protein excretion, which can induce mesangial changes and be improved by ACE inhibitor treatment.
Ha
Tae-Sun
TS
Department of Pediatrics, Chungbuk National University Hospital, Gaesin-dong 62, Heungdeok-gu, Cheongju, Chungbuk, 361-240, South Korea. tsha@chungbuk.ac.kr
Lee
Eun-Ju
EJ
D000293:Adolescent; D000792:Angiography; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002648:Child; D003250:Constriction; D018450:Disease Progression; D005260:Female; D005920:Glomerular Mesangium / Q000473:pathology; D006801:Humans; D011187:Posture; D011507:Proteinuria / Q000188:drug therapy* / Q000209:etiology; D012082:Renal Veins / Q000473:pathology*; D013577:Syndrome; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors