Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016199 (flank pain)
 2,189 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Xanthogranulomatous pyelonephritis is an uncommon variant of chronic pyelonephritis that predominantly affects middle-aged women. Patients usually present with fever, back or flank pain, flank mass, and the constitutional symptoms of fatigue, malaise, weight loss, and anorexia. Rarely, they may present with a draining sinus. There is usually a history of urinary tract infection, obstruction, or instrumentation. Other abnormalities include anemia, leukocytosis, abnormal liver enzymes, pyuria, and hematuria. Mild azotemia may be present, but frank renal failure is rare. Urine and renal tissue cultures are frequently positive. The most commonly isolated bacterial pathogens are P. mirabilis and E. coli, but other organisms have also been implicated. A CT scan is the best radiologic imaging technique to discover the extent of inflammation as well as any involvement of adjacent structures. Lipid-laden macrophages called xanthoma cells characterize the disease at the microscopic level. Nephrectomy is curative. Careful preoperative evaluation will guide surgical planning in choosing an approach that provides adequate exposure of the affected tissue and facilitates subsequent care of the patient.
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PMID:A middle-aged woman with back and flank pain. 881 29

Renal Cell Carcinoma is the third most common malignoma in urology. Only little is known about the etiology and risk factors; the age peak lies at 60 and twice as many men than women are affected. The clinical picture presents with a wide spectrum. Over one third of all tumours are detected accidentally by ultrasound or computed tomography in asymptomatic patients. Most common symptoms are hematuria and flank pain, the classical trials including in addition a palpable mass is rare and by mo means an early symptom. Paraneoplastic syndromes include unspecific (increased blood sedimentation rate, weight loss, fever) and endocrine symptoms (hypertension, polyglobulia, hypercalcemia). Diagnosis is based on imaging procedures. By means of sonography renal cysts may be separated from solid, space-occupying tumors. For the latter CT plays a decisive role for staging, therapeutic planning and prognosis. Further radiologic investigations (angiography, MRI) are indicated only in special situations. Rarely a biopsy is necessary for the distinction between renal cell carcinoma and metastases of other primary tumors. The only curative treatment of localized carcinoma is radical nephrectomy. Partial resection is indicated in cases of a single kidney, bilateral tumors and possibly also for tumors smaller than 4 cm in diameter. Radiotherapy is only initiated for palliation of painful skeletal metastases. In case of distant metastases--mainly pulmonary--nephrectomy should only be performed if systemic treatment is planned or if local complaints (pain, hematuria leading to anemia) exist. Chemotherapeutic drugs have no influence on survival. The effect of gestagens on life quality is questionable. Adoptive immunotherapy with cytokines (Interferon-alpha, interleukin-2) appears most promising. These substances, however, not yet been introduced into routine therapy should only be used in prospective studies. Furthermore, renal cell carcinoma is a potential candidate for gene therapy. After tumor nephrectomy follow-up investigations should be performed twice a year, because of the possibility of curative surgical treatment of late solid metastases. Prognosis of tumors restricted to the organ is good. Five year survival after operation is about 90%. However, is distant metastases exist already at the time of diagnosis 5 year survival drops to less than 10%.
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PMID:[Renal cell carcinoma--a current review]. 931 11

Thrombotic thrombocytopenic purpura (TTP) is a rare disease whose incidence is now increasing. We present a case of a 37-year-old man who presented with bilateral flank pain and hematuria, subsequently diagnosed with TTP. Thrombotic thrombocytopenic purpura has classically been characterized by the pentad of fever, microangiopathic hemolytic anemia, neurologic symptoms, renal dysfunction, and thrombocytopenia. The pathogenesis of the disease has been a mystery until recently. We review the current literature regarding the pathophysiology and management of this disorder. Our discussion focuses on the importance of understanding this disease while considering the differential diagnosis of a patient presenting with anemia and thrombocytopenia because the common pitfall of rapidly administering platelets to a patient with TTP may lead to a disastrous outcome.
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PMID:Thrombotic thrombocytopenic purpura presenting as bilateral flank pain and hematuria: a case report. 1139 82

We report a giant renal adenocarcinoma (5150 g weight) excised in a 52 years old male. He presented a severe clinical symptoms: serious haematuria, fever (40 degrees C), left flank pain, abdominal discomfort and weight loss (10 kg). The patient underwent left renal artery embolization because of severe anemia (blood transfusion: 4 uu) but haematuria didn't decrease; that's why radical surgery was advised. Until our knowledge this case is the largest removed kidney adenocarcinoma published in the world literature (Medline 1966-2001).
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PMID:[Nephrectomy of a giant hypernephroma (5,150 g)]. 1218 41

A 14.5-year-old girl with Fraley's syndrome, which caused left flank pain and massive haematuria with anaemia underwent left renal surgery. The infundibulum for the left upper calyx group was entrapped between the lower segmental renal artery and one branch of the renal vein. Despite other known surgical procedures, the surgeon explored the area around the entrapped infundibulum and resected the vein. Impression of the infundibulum disappeared, the dilatation of the upper calyces diminished, the pain was immediately relieved, and the haematuria stopped. In the two-year follow-up period the patient remained healthy, without haematuria or a subjective feeling of illness. The surgical treatment performed was successful, and it is also one of the most nephron-sparing procedures available.
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PMID:A nephron-sparing surgical procedure for Fraley's syndrome. A case report. 1246 64

The finding of acute flank pain, hypotension and anemia in the absence of trauma raises concerns about retroperitoneal bleeding. This article highlights the rare case of a patient with a bleeding retroperitoneal angiomyolipoma.
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PMID:Successful embolization of retroperitoneal bleeding from a renal angiomyolipoma. 1276 15

This is a case presentation and discussion of a dialysis patient who presented to the surgical service with abdominal pain, hypotension, and tachycardia and in extremis who was found to have a contained retroperitoneal hematoma after rupture of his left kidney. Six months after an uneventful nephrectomy and postoperative recovery he again presented with hypotension and anemia and was found to have a contralateral retroperitoneal hematoma consistent with renal hemorrhage. After unsuccessful angioembolization, the patient underwent a right nephrectomy and recovered without sequelae. Bilateral spontaneous renal rupture is a rare event documented by only a few anecdotal reports in the literature and usually associated with acquired cystic kidney disease. Rupture of renal cysts is relatively common in renal cystic disease but usually presents as asymptomatic hematuria or flank pain. Trauma is the most common cause of renal rupture, but other causes of spontaneous renal rupture are rare and include polyarteritis nodosa and urothelial carcinoma. The diagnosis of acute abdominal pain in the dialysis patient is a challenging differential. While a rare complication the diagnosis of spontaneous renal rupture should not be excluded in a patient presenting with abdominal pain, hypotension, and anemia.
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PMID:Bilateral renal rupture in a patient on hemodialysis. 1285 8

Retroperitoneal fibrosis (RF) is a rare disease, typically with an insidious clinical course. The peak incidence is seen in patients 40 to 60 years of age and mostly in man. The characteristic finding in this disease is a periaortic fibrous mass that often surrounds the ureters. Although usually regarded as an obstructive uropathy, there has been growing recognition of the condition as a generalized disease. It may have a wide variety of manifestations including mediastinitis, thyroiditis and sclerosing cholangitis. The most common mode of presentation remains abdominal or flank pain with uremia, anemia and a high sedimentation rate. Although ultrasound and renal scintigraphy may contribute to the general evaluation of patients with RF, CT-scanner is the preferred imaging method. The multiplanar imaging capability of magnetic resonance may facilitate assessment of disease extent. The pathogenesis of the disease remains unknown. Steroids and, more recently tamoxifen, appear to be effective in the treatment of the RF. In most instances, RF does not lead to long-term morbidity or affect survival. The three cases of RF reported herein illustrate the varied mode of presentation and the response to the treatment.
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PMID:[Retroperitoneal fibrosis, an unrecognized inflammatory disease. Clinical observations and review of the literature]. 1289 32

An 81-year-old woman presented with left-flank pain, anaemia and a fast irregular pulse while using oral anticoagulation. Diagnostic investigation revealed retroperitoneal bleeding caused by a medium-sized renal angiomyolipoma. Angiomyolipoma was also found in the contralateral kidney. No tuberous sclerosis was ascertained. Bleeding stopped after discontinuation of anticoagulant therapy. Renal angiomyolipoma is an uncommon benign tumour which is frequently associated with tuberous sclerosis. Spontaneous retroperitoneal bleeding is a potentially life-threatening complication. This type of tumour is usually found incidentally on radiological examination.
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PMID:[Retroperitoneal bleeding caused by renal angiomyolipoma]. 1451 42

Renal cell carcinoma was diagnosed in three male patients, 45, 53 and 52 years of age. In addition, they had paraneoplastic symptoms: hypercalcaemia, hyperglycaemia and elevated hepatic enzyme levels, respectively. All three patients underwent tumour nephrectomy, after which the paraneoplastic symptoms disappeared. The first patient died 16 months postoperatively, while the other two were alive and free of symptoms after a follow-up of nine months and four years, respectively. Many patients with renal cell carcinoma remain asymptomatic for a long period of time and 30% of all patients have metastatic disease at the time of diagnosis. The classic triad of flank pain, haematuria and an abdominal mass occurs in only 10% of all cases. However, 20-40% of all patients present with signs of a paraneoplastic syndrome, of which anaemia (20-40%), fever (30%), hypertension (24%), hypercalcaemia (10-15%) and hepatic dysfunction (3-6%) are the most common.
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PMID:[Paraneoplastic syndromes in three patients with renal cell carcinoma]. 1518 42


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