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ACE inhibition can improve orthostatic proteinuria associated with nutcracker syndrome

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Abstract

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.

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References

  1. Takahashi Y, Shintaku N (1991) Left renal vein entrapment. Pediatr Nephrol 5:368–369

    Article  Google Scholar 

  2. Stewart BH, Reiman G (1982) Left renal venous hypertensive nutcracker syndrome. Managed by direct renocaval reimplantation. Urology 20:365–369

    Article  CAS  Google Scholar 

  3. Shintaku N, Takahashi Y, Akaishi K, Sano A, Kuroda Y (1990) Entrapment of left renal vein in children with orthostatic proteinuria. Pediatr Nephrol 4:324–327

    Article  CAS  Google Scholar 

  4. Lee SJ, You ES, Lee JE, Chung EC (1997) Left renal vein entrapment syndrome in two girls with orthostatic proteinuria. Pediatr Nephrol 11:218–220

    Article  CAS  Google Scholar 

  5. Springberg PD, Garret LE, Thompson AL, Collins NF, Lordon RE, Robinson KR (1982) Fixed and reproducible orthostatic proteinuria: results of a 20 year follow-up study. Ann Intern Med 97:516–519

    Article  CAS  Google Scholar 

  6. Robinson RR, Ashworth CT, Glover SM, Phillippi PF, Lecocq FR, Langelier PR (1961) Fixed and reproducible orthostatic proteinuria. I. Light microscopic studies of the kidney. Am J Pathol 39:291–301

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Buchanec J, Kliment J, Javorka K, Belakova S (1983) X-ray changes in the kidneys of children with orthostatic proteinuria. Int Urol Nephrol 15:3–9

    Article  CAS  Google Scholar 

  8. Vehaskari VM (1990) Mechanism of orthostatic proteinuria. Pediatr Nephrol 4:328–330

    Article  CAS  Google Scholar 

  9. Yoshioka T, Mitarai T, Kon V, Deen WM, Rennke HG, Ichikawa I (1986) Role of angiotensin II in an overt functional proteinuria. Kidney Int 30:538–545

    Article  CAS  Google Scholar 

  10. Yoshioka T, Rennke HG, Salant DJ, Deen WM, Ichikawa I (1987) Role of abnormally high transmural pressure in the permselectivity defect of glomerular capillary wall: a study in early passive Heymann nephritis. Circ Res 61:531–538

    Article  CAS  Google Scholar 

  11. Remuzzi G, Bertani T (1998) Pathophysiology of progressive nephropathies. N Engl J Med 339:1448–1456

    Article  CAS  Google Scholar 

  12. Aros C, Remuzzi G (2002) The renin-angiotensin system in progression, remission and regression of chronic nephropathies. J Hyperten 20[Suppl 3]:S45–S53

    CAS  Google Scholar 

  13. Ruiz-Ortega M, Lorenzo O, Suzuki Y, Ruperez M, Egido J (2001) Pro-inflammatory actions of angiotensins. Curr Opin Nephrol Hypertens 10:321–329

    Article  CAS  Google Scholar 

  14. Keane WF, Raij L (1985) Relationship among altered glomerular barrier permselectivity, angiotensin II, and mesangial uptake of macromolecules. Lab Invest 52:599–604

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Chungbuk National University Hospital, Gaesin-dong 62, Heungdeok-gu, Cheongju, Chungbuk, 361-240, South Korea

    Tae-Sun Ha & Eun-Ju Lee

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  1. Tae-Sun Ha
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  2. Eun-Ju Lee
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Correspondence to Tae-Sun Ha.

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Ha, TS., Lee, EJ. ACE inhibition can improve orthostatic proteinuria associated with nutcracker syndrome. Pediatr Nephrol 21, 1765–1768 (2006). https://doi.org/10.1007/s00467-006-0206-3

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  • DOI: https://doi.org/10.1007/s00467-006-0206-3

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