Symptomatic renal papillary varicosities and medullary nephrocalcinosis

Abstract Background Nephrocalcinosis is often asymptomatic but can manifest with renal colic or hematuria. There is no reported association between nephrocalcinosis and renal vascular malformations, which may also be a source of hematuria. We herein present a case of a patient with hematuria related...

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Autores principales:	Brent Cleveland, Michael Borofsky
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Renal papillary varicosity Renal vascular malformation Nephrocalcinosis Essential hematuria Laser fulguration Case report Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/ad5a29c8b4a145e092a1cb05de68010a
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spelling	oai:doaj.org-article:ad5a29c8b4a145e092a1cb05de68010a2021-12-05T12:19:55ZSymptomatic renal papillary varicosities and medullary nephrocalcinosis10.1186/s12894-021-00931-31471-2490https://doaj.org/article/ad5a29c8b4a145e092a1cb05de68010a2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12894-021-00931-3https://doaj.org/toc/1471-2490Abstract Background Nephrocalcinosis is often asymptomatic but can manifest with renal colic or hematuria. There is no reported association between nephrocalcinosis and renal vascular malformations, which may also be a source of hematuria. We herein present a case of a patient with hematuria related to nephrocalcinosis and renal papillary varicosities. These varicosities were diagnosed and successfully treated with flexible ureteroscopy and laser fulguration. Case presentation A 24-year-old female with a history of epilepsy (on zonisamide), recent uncomplicated pregnancy, and new diagnosis of nephrocalcinosis presented with right flank pain and intermittent gross hematuria. Imaging revealed intermittent right sided hydronephrosis. A cystoscopy identified hematuria from the right ureteral orifice. Diagnostic flexible ureteroscopy revealed numerous intrapapillary renal stones and varicose veins of several renal papillae. A 200 μm holmium laser fiber was used to unroof these stones and fulgurate the varicosities with resolution of her symptoms for several months. She later presented with left-sided symptoms and underwent left ureteroscopy with similar findings and identical successful treatment. Conclusion Unilateral hematuria from discrete vascular lesions of the renal collecting system may be obscured by other benign co-existing conditions, such as nephrocalcinosis and nephrolithiasis. Although a simultaneous presentation is rare, flexible ureteroscopy with laser fulguration offers an ideal diagnostic and therapeutic modality for these concurrent conditions if symptoms arise.Brent ClevelandMichael BorofskyBMCarticleRenal papillary varicosityRenal vascular malformationNephrocalcinosisEssential hematuriaLaser fulgurationCase reportDiseases of the genitourinary system. UrologyRC870-923ENBMC Urology, Vol 21, Iss 1, Pp 1-4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Renal papillary varicosity Renal vascular malformation Nephrocalcinosis Essential hematuria Laser fulguration Case report Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Renal papillary varicosity Renal vascular malformation Nephrocalcinosis Essential hematuria Laser fulguration Case report Diseases of the genitourinary system. Urology RC870-923 Brent Cleveland Michael Borofsky Symptomatic renal papillary varicosities and medullary nephrocalcinosis
description	Abstract Background Nephrocalcinosis is often asymptomatic but can manifest with renal colic or hematuria. There is no reported association between nephrocalcinosis and renal vascular malformations, which may also be a source of hematuria. We herein present a case of a patient with hematuria related to nephrocalcinosis and renal papillary varicosities. These varicosities were diagnosed and successfully treated with flexible ureteroscopy and laser fulguration. Case presentation A 24-year-old female with a history of epilepsy (on zonisamide), recent uncomplicated pregnancy, and new diagnosis of nephrocalcinosis presented with right flank pain and intermittent gross hematuria. Imaging revealed intermittent right sided hydronephrosis. A cystoscopy identified hematuria from the right ureteral orifice. Diagnostic flexible ureteroscopy revealed numerous intrapapillary renal stones and varicose veins of several renal papillae. A 200 μm holmium laser fiber was used to unroof these stones and fulgurate the varicosities with resolution of her symptoms for several months. She later presented with left-sided symptoms and underwent left ureteroscopy with similar findings and identical successful treatment. Conclusion Unilateral hematuria from discrete vascular lesions of the renal collecting system may be obscured by other benign co-existing conditions, such as nephrocalcinosis and nephrolithiasis. Although a simultaneous presentation is rare, flexible ureteroscopy with laser fulguration offers an ideal diagnostic and therapeutic modality for these concurrent conditions if symptoms arise.
format	article
author	Brent Cleveland Michael Borofsky
author_facet	Brent Cleveland Michael Borofsky
author_sort	Brent Cleveland
title	Symptomatic renal papillary varicosities and medullary nephrocalcinosis
title_short	Symptomatic renal papillary varicosities and medullary nephrocalcinosis
title_full	Symptomatic renal papillary varicosities and medullary nephrocalcinosis
title_fullStr	Symptomatic renal papillary varicosities and medullary nephrocalcinosis
title_full_unstemmed	Symptomatic renal papillary varicosities and medullary nephrocalcinosis
title_sort	symptomatic renal papillary varicosities and medullary nephrocalcinosis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/ad5a29c8b4a145e092a1cb05de68010a
work_keys_str_mv	AT brentcleveland symptomaticrenalpapillaryvaricositiesandmedullarynephrocalcinosis AT michaelborofsky symptomaticrenalpapillaryvaricositiesandmedullarynephrocalcinosis
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Symptomatic renal papillary varicosities and medullary nephrocalcinosis

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