Treatment of loin pain hematuria syndrome by renal autotransplantation

Abstract

Loin pain hematuria (LPH) syndrome is a poorly understood and relatively rare symptom complex, but one that increasingly deserves recognition as a clinical entity. The syndrome lacks specific diagnostic criteria, but patients with this condition, most frequently female, present with microscopic hematuria and incapacitating loin pain, usually leading to narcotic addiction. The appellation LPH syndrome was first applied by Little and associates [ 11, who described the original cases in England. Since then, no more than 130 cases have been described around the world. Various pathogenetic mechanisms have been postulated and a multitude of therapies attempted, but the entity remains a diagnostic enigma and a therapeutic dilemma for patient and physician alike. The patient described herein is presented to heighten the awareness of American physicians concerning this obscure syndrome and to suggest renal autotransplantation, to date employed mainly by the Australians, as a therapeutic option. The case report is accompanied by a chronologic review of the existing literature concerning this entity.