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)

Cantharidin, known popularly as Spanish fly, has been used for millennia as a sexual stimulant. The chemical is derived from blister beetles and is notable for its vesicant properties. While most commonly available preparations of Spanish fly contain cantharidin in negligible amounts, if at all, the chemical is available illicitly in concentrations capable of causing severe toxicity. Symptoms of cantharidin poisoning include burning of the mouth, dysphagia, nausea, hematemesis, gross hematuria, and dysuria. Mucosal erosion and hemorrhage is seen in the upper gastrointestinal (GI) tract. Renal dysfunction is common and related to acute tubular necrosis and glomerular destruction. Priapism, seizures, and cardiac abnormalities are less commonly seen. We report four cases of cantharidin poisoning presenting to our emergency department with complaints of dysuria and dark urine. Three patients had abdominal pain, one had flank pain, and the one woman had vaginal bleeding. Three had hematuria and two had occult rectal bleeding. Low-grade disseminated intravascular coagulation, not previously associated with cantharidin poisoning, was noted in two patients. Management of cantharidin poisoning is supportive. Given the widespread availability of Spanish fly, its reputation as an aphrodisiac, and the fact that ingestion is frequently unwitting, cantharidin poisoning may be a more common cause of morbidity than is generally recognized. Cantharidin poisoning should be suspected in any patient presenting with unexplained hematuria or with GI hemorrhage associated with diffuse injury of the upper GI tract.
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PMID:Poisoning from "Spanish fly" (cantharidin). 876 16

Fibroangiomatous polyps and its histological variants most often occur in the ureters of young adult. They may be multiple, and rarely occur in the renal pelvis. Microscopically, normal or hyperplastic urothelium cover loose, vascular, edematous, fibrous stroma that may be inflamed. Etiologic factors are unknown. Intermittent flank pain is the most common symptom; dysuria and hematuria occur less frequently. A case of fibroangiomatous polyps of the left ureter, in a 37-years old woman, is presented. We emphasize the endoscopic conservative treatment of this lesion as a valid alternative to the surgical approach; beside, it's important to obtain pre-operative histological finding, confirming the benign lesion.
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PMID:[Polyp fibroangioma of the ureter. Endoscopic treatment]. 892 90

Complications resulting from persistent and repeated urinary tract infections (UTIs) account for nearly 1 million hospital admissions annually. Cystitis, a localized bladder infection occurring in the lower tract, is recognized by a symptom complex of dysuria, frequency, urgency, and suprapubic tenderness; pyelonephritis, which refers to upper tract infection of the kidneys, classically manifests with flank pain and systemic as well as cystitis signs. An empiric 3-day antibiotic regimen has been shown to be more than 95% effective in curing cystitis. But for a subgroup of patients, a relapse of "cystitis" within 4 weeks can signal a subclinical, "silent," pyelonephritis. A 14-day course of antibiotics is indicated to treat the recurrent UTI. Follow-up urinalysis and urine cultures are then repeated 2 and 4 weeks after therapy. If symptoms and/or bacteriuria are again documented with the same organism, subclinical pyelonephritis is presumed; a prolonged 6-week course of antibiotics is then warranted to prevent prolonged problems and complications associated with UTIs. When the problem is reinfection with a microorganism different from that responsible for the last infection, short-course therapy for 3 days may be prescribed for each episode. When reinfection occurs more frequently than 2 to 3 times a year, however, antibiotic prophylaxis to prevent reinfections is warranted.
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PMID:Can a Silent Kidney Infection or Genetic Predisposition Underlie Recurrent UTIs? 974 44

A 17-year-old female was admitted to the hospital with symptoms of right-sided abdominal and flank pain, slight dysuria, and tactile temperature. Her presumptive diagnosis was pyelonephritis. She weighed 73.5 kg and had had a previous normal pregnancy. Pathology revealed multiple yellow calculi with thickened wall of the gallbladder, consistent with chronic pyelonephritis. She continued to have intermittent symptoms and underwent laparoscopic cholecystectomy 2 months after admission.
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PMID:A Change in Diagnosis of Abdominal Pain. 1035 78

A 14-year-old female was seen for acute abdominal, back, and flank pain, accompanied with dysuria, increased frequency of urination, nausea, and decreased appetite. After an initial diagnosis of pyelonephritis, a presumptive diagnosis of pelvic inflammatory disease (PID) was made. The cervical culture was positive for Chlamydia trachomatis and a pelvic sonogram demonstrated abnormal right adnexal structures and a possible mass. Exploratory laparotomy was performed, which demonstrated right-sided inflammation in the fimbria and fallopian tube as well as an ovarian cyst on the right. Her postoperative course was uncomplicated and was continued on oral doxycycline.
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PMID:PID or Not PID? That Is the Question. 1035 92

To evaluate urinary NMP22 dosage as a marker of urothelial tumours, we have selected a group of 90 patients (85 males and 5 females, mean age 66 years) with clinical suspicion of transitional cell carcinoma (TCC), with microscopic or macroscopic hematuria, flank pain, urographic abnormalities and dysuria. All the patients have been evaluated by urinary cytology, renal and bladder ultrasound, cystoscopy. When a bladder tumour has been detected, bladder biopsies and, when required, I.V.P., CT or retrograde pyelography have been performed. A urine sample has been collected between midnight and noon; all samples from patients who were undergoing invasive procedures such as cystoscopy, were collected before or at least 5 days after the procedure. The test has been performed according to ELISA NMP22 (Matritech) technique; the test is specific for the nuclear matrix protein/nuclear mitotic apparatus protein expressed by cancer cells. When performing the test, 30 patients presented macroscopic hematuria. 22 patients resulted to have benign urinary tract conditions, 65 patients had TCC and 3 patients had a final evaluation suspicious for TCC. The NMP22 values were respectively 7.1 +/- 4.7 U/ml, 21.9 +/- 21.0 U/ml and 16 +/- 8.0 U/ml. From our study the sensitivity of the test is 67% (with a threshold value of 10 U/ml) and 55% (with a threshold value of 20 U/ml), while the urinary cytology resulted to have a sensitivity of 26% (p < 0.05). The sensitivity of the test in relation to staging was as follow: Tis 66% with a mean NMP22 value of 23.3 U/ml, Ta 26% with a mean NMP22 value of 13.2 U/ml, T1 100% with a mean NMP22 value of 40 U/ml, T2 73% with a mean NMP22 value of 36.4 U/ml. The specificity of the test was 100% with a threshold value of 20 U/ml. When considering a threshold value of 10 U/ml, the NMP22 test has a sensitivity higher than cytology, especially in low stage TCC. Macroscopic hematuria does not affect its sensitivity; the diagnostic efficacy of the test is not increased by the association of urinary cytology. It has an important role in the diagnosis of residual disease after TURB and in the follow-up evaluation of bladder cancer patients, since its dosage is not influenced by inflammatory conditions of the mucosa. We believe therefore that NMP22 is useful in clinical practice.
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PMID:[Urinary NMP22 as a new marker in patients with transitional cell carcinoma]. 1043 9

Indinavir sulfate has been reported to cause asymptomatic crystalluria and nephrolithiasis in patients with human immunodeficiency virus (HIV) infection. Patients taking indinavir may present with asymptomatic crystalluria, nephrolithiasis with frank renal colic and obstruction, flank pain in the absence of nephrolithiasis, and dysuria or urgency. Asymptomatic crystalluria has been described as benign. Discontinuation of the drug has not been recommended in the absence of nephrolithiasis. We report two HIV-positive patients receiving indinavir who developed acute interstitial nephritis with foreign body giant cell reaction on renal biopsies. Both patients had asymptomatic crystalluria, although crystals were associated with clumps of white blood cells (WBCs) on urinalysis in one patient. Both cases show that the inflammatory response was significant enough to lead to tubular injury and acute renal impairment. Our findings suggest that asymptomatic crystalluria attributable to indinavir may illicit an inflammatory response with acute renal insufficiency, warranting monitoring of renal function, especially in patients with crystalluria.
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PMID:Acute tubulointerstitial nephritis attributable to indinavir therapy. 1073 9

Urinary tract infection (UTI) is common in postmenopausal women; the estimated incidence ranges from 4% to 15%. The clinical presentation of UTI is somewhat different in postmenopausal older women than it is in younger women: postmenopausal women are less likely to report frequency, dysuria, hematuria, and fever, but are more likely to report flank pain. Other than UTI history, risk factors for symptomatic UTI among postmenopausal women are poorly described. Hormonal replacement therapy minimizes physiologic changes associated with menopause that lead to genitourinary symptoms and, potentially, to UTI, but whether this therapy is appropriate for the prevention of recurrent UTI in postmenopausal women is uncertain.
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PMID:Urinary Tract Infection in Postmenopausal Women. 1109 10

Retroaortic left renal vein joining the left common iliac vein is a rare congenital anomaly in the development of the inferior vena cava. To our knowledge, only one case has been reported in the literature; however, its imaging features have never been described. A 27-year-old male presented with a 1-year history of recurrent right flank pain, dysuria, hematuria, and fever (39 degrees C). Computed tomography and MR venography showed a retroaortic left renal vein joining the left common iliac vein. We present the CT and MR venography findings and discuss their feasibility in showing this congenital anomaly.
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PMID:Retroaortic left renal vein joining the left common iliac vein. 1109 97

Idiopathic hypercalciuria (IHC) has been reported mainly in children with hematuria in the 1980s and early 1990s, when renal sonography was just becoming routine. The presence of microcalculi, i.e., of hyperechogenic spots < 3 mm in diameter in renal calyces, was not taken into account in those studies. We attempted to outline clinical presentation and natural course of IHC not only in children with hematuria, but also in those with dysuria and/or recurrent abdominal/flank pain and a family history of nephrolithiasis, taking into account the finding of microcalculi. We analyzed retrospectively the data at diagnosis from 74 consecutive children aged 2.4-18 years (mean 8.6) with IHC (calciuria 4.1-15.1 mg kg-1 24 h-1, mean 6.1) and the outcome of 30 of them who were followed > or = 1 years (mean 3.2) with no specific therapy. At diagnosis, 38 patients (51%) had no hematuria, 42 (57%) had microcalculi and four (5%) had calculi. Of the patients with normal urinalysis, 71% had microcalculi or stones. The subjects with microcalculi and those with stones were significantly older than those without microcalculi and stones (P = 0.004 and 0.007). A normal urinalysis at our evaluation and a history of abdominal/flank pain were significantly more frequent in patients with microcalculi than in those without (P = 0.02 and 0.0001, respectively). During the follow-up, four of 30 patients formed stones 1-3 years after first diagnosis of IHC. More than half of children with IHC have microcalculi. The risk of formation of microcalculi or stones increases with age. The lack of hematuria does not exclude the presence of microcalculi or calculi. Hypercalciuria has to be suspected in children with dysuria and/or recurrent abdominal flank pain and a family history of nephrolithiasis, even when they have no hematuria.
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PMID:Clinical presentation and natural course of idiopathic hypercalciuria in children. 1114 13


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