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Haematuria without diagnosis? Think about the rare causes…
  1. Ana Sofia Esteireiro1,
  2. Pedro Santos2 and
  3. Anabela Bicho1
  1. 1Department of Paediatrics, Centro Hospitalar do Oeste, Unidade de Caldas da Rainha, Caldas da Rainha, Portugal
  2. 2Department of Imaging, Centro Hospitalar do Oeste, Unidade de Caldas da Rainha, Caldas da Rainha, Portugal
  1. Correspondence to Dr Ana Sofia Esteireiro; esteireira{at}


We describe a case of a 17-year-old man admitted in the emergency room with a 2-month history of intermittent macroscopic haematuria and left lumbar pain. Physical examination and vital signs were normal. Investigation indicated a recurrent non-glomerular haematuria. The Doppler ultrasound revealed a compression of the left renal vein with upstream dilatation which was subsequently confirmed by CT angiography. These findings are in keeping with a case of nutcracker syndrome (NutS). Although asymptomatic in most cases, it can be a rare cause of haematuria. The teenager was referred to paediatric nephrology and was treated conservatively with spontaneous resolution of macroscopic haematuria. With this case, we would like to highlight that in children or adolescents with haematuria without an apparent cause, a high level of suspicion and appropriate imaging are necessary for the diagnosis of NutS.

  • paediatrics (drugs and medicines)
  • urinary and genital tract disorders
  • hematuria
  • urology

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  • Contributors ASE: She was the main author and responsible for manuscript writing. She also followed the patient. PS: He helped in the confirmation of the diagnosis doing the imagiological exams. He also contributed for the article review. AB: She followed the patient and also reviewed the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.