This study aims to remind clinicians of this "forgotten" diagnosis and what signs to look for in pediatric patients with sickle cell disease who present with hematuria. [ncbi.nlm.nih.gov]

• Left Flank Pain

  A 58-year-old female diabetic patient complaining of left flank pain, fever and chills was admitted to our clinic. She had no past history of analgesic abuse or atypical vasculitis. [researchgate.net]

  A woman, aged sixty two, with the history of pyelonephritis, suddenly started to complain severe left flank pain with fever, three weeks after lumbar trauma by traffic accident. [webview.isho.jp]

  The patient was a 51-year-old man with poorly controlled diabetes and a history of microhematuria and an acute onset of severe left flank pain. [emedicine.medscape.com]

• Lower Abdominal Pain

  […] and lower abdominal pain. [ncbi.nlm.nih.gov]

• Hematuria

  The management of the primary clinical manifestations of this disorder, hematuria and papillary necrosis, are discussed. [ncbi.nlm.nih.gov]

  Abstract A patient with sickle cell trait who presented with gross hematuria and was subsequently found to have renal papillary necrosis is presented. [jasn.asnjournals.org]

  Sickle cell disease should be considered in patients with unexplained hematuria. A 26-year-old healthy Greek woman was evaluated because of new-onset painless hematuria. The physical examination was unremarkable. [nejm.org]

• Flank Pain

  We describe a patient with bilateral RPN and EPN caused by Candida tropicalis, who suffered from recurrent hematuria, flank pain, acute fulminant renal failure, and obstruction by a sloughed papilla. [ncbi.nlm.nih.gov]

  […] dilated renal pelvis at the level of the proximal ureter Congenital ureterovesical junction obstruction Asymptomatic or intermittent flank pain Ultrasonography Hydronephrosis, megaureter Renal cell carcinoma Triad of flank pain, gross hematuria, and [aafp.org]

  Calyceal or ureteral obstruction by sloughed papillae manifest with flank pain, hematuria and varying degrees of renal impairment. Anuria or oliguria may be present in the fulminant stage, if renal failure develops. [radiopaedia.org]

  […] and/or abdominal pain Hematuria Acute ureteral obstruction from sloughed papillae manifests as flank pain and colic from hydronephrosis or pyonephrosis Hematuria is almost always present Clinical picture in such cases may also include fever, chills and [learningradiology.com]

• Anuria

  Anuria or oliguria may be present in the fulminant stage, if renal failure develops. Urinary stasis leads to pyelonephritis with fever, chills or rigors. [radiopaedia.org]

  Acute renal failure and oliguria or anuria occurs, but when it does, the disease may be fulminant, requiring dialysis and potentially resulting in death. [casereports.in]

  Acute renal failure with oliguria or anuria is rare presentation. In Acute RPN, kidneys appear enlarged and in chronic type, patchy papillary or calyceal changes are seen in early stages and all papillae are affected to some extent in later stages. [ncbi.nlm.nih.gov]

  Acute renal failure with oliguria or anuria is rare; when these symptoms develop, the disease may be fulminant, requiring dialysis and potentially resulting in death. [emedicine.medscape.com]

Patients who present with hematuria, even if diagnostic interventions indicate papillary necrosis, require a full urologic workup for their hematuria because they may have a concomitant bladder tumor or similar lesion. [emedicine.medscape.com]

Signs: Patients who present with hematuria, even if diagnostic interventions indicate papillary necrosis, require a full urologic workup for their hematuria because they may have a concomitant bladder tumor or similar lesion. [medigoo.com]

• Nephrolithiasis

  Nephrolithiasis and nephrocalcinosis. In: Johnson RJ, Feehally J, Floege J, eds. Comprehensive Clinical Nephrology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 59. Landry DW, Bazari H. Approach to the patient with renal disease. [nlm.nih.gov]

  The symptomatic form manifests as an episode of pyelonephritis and hydronephrosis and it mimics nephrolithiasis. The most common presenting symptoms of symptomatic patients are fever and chills, flank and/or abdominal pain and hematuria. [casereports.in]

  Nephrolithiasis Hypercalcaemia: nepthocalcinosis Hyperthyroid, multiple myeloma, xs VitD, mets, milk-alkali syndrome Calcium stones Can't conc ATN with acidosis, salt wasting Acute phosphate nephropathy Calcium phosphate Dialysis may be required Fistulae [alancam.com]

• Ischemic Changes

  […] pyramid (1) Urographic findings during this period of early ischemic change are usually normal. [dxradiologia.wordpress.com]

  Early ischemic change in the medullary pyramid in a 50-year-old man with diabetes. [doi.org]

  Infection that causes inflammation of the interstitium also may lead to compression of the medullary vasculature and thus predispose the vessels to ischemic change. [medigoo.com]

  Lang et al describe the ischemic changes of early medullary and papillary necrosis as "a circumscribed, yet often poorly marginated area of diminished enhancement in the tip of the medullary period." [emedicine.medscape.com]

The case illustrates a potential hazard of this combination in the acute treatment of migraine. [ncbi.nlm.nih.gov]

Treatment There is no specific treatment for renal papillary necrosis. If analgesic nephropathy is suspected as the cause, stop the use of suspected medications. This may allow spontaneous healing over time. [medical-dictionary-search-engines.com]

The second edition concludes with current and developing approaches to treatment, incorporating new agents for iron chelation, methods to induce fetal hemoglobin production, novel treatment approaches, stem cell transplantation, and progress in gene therapy [books.google.com]

Destruction of the renal papilla may result in: (1) secondary degenerative cortical changes which precede chronic renal failure or (2) a rapidly metastasizing upper urothelial carcinoma, which has a very poor prognosis. [ncbi.nlm.nih.gov]

The application of this imaging modality may translate into significant short-term improvements in the evolution and prognosis of these patients. [repositorio.uchile.cl]

Acute interstitial nephritis generally has a good prognosis. [amboss.com]

Expectations (prognosis) The probable outcome varies. If the underlying disorder can be controlled, a spontaneous remission is possible. The progression to renal failure is also possible. [medical-dictionary-search-engines.com]

Abstract The radiological changes of renal papillary necrosis are independent of its etiology. If total papillary necrosis (TPN) or partial papillary necrosis (PPN) is present, radiological findings are diagnostic. [ncbi.nlm.nih.gov]

Etiologies are covered by the mnemonic POSTCARD: pyelonephritis, obstruction, sickle cell anemia, tuberculosis, cirrhosis, analgesics, renal vein thrombosis, and diabetes mellitus. [med-ed.virginia.edu]

Epidemiology Analgesic nephropathy occurs in about 4 out of 100,000 people - mostly women aged over 30. [ 4 ] In an Australasian study, of 31,654 renal replacement therapy patients, 10.2% had analgesic nephropathy. [ 5 ] In contrast, a Swiss study found [patient.info]

Methods Statistics Trigonometry Medical & Nursing Anatomy Anesthesiology Audiology Bacteriology Biochemistry Bioethics Biomedical Science Cardiology Cardiovascular Childbirth Chiropractic Dentistry Dermatology Diagnostic Imaging Drugs Endocrinology Epidemiology [brainscape.com]

Renal stone epidemiology: a 25-year study in Rochester, Minnesota. Kidney Int 1979;16:624–631. 5. Coe FL, Parks JH, Asplin JR. The pathogenesis and treatment of kidney stones. N Engl J Med 1992;327:1141–1152. 6. [synapse.koreamed.org]

This can happen by continuing to demand and generate the best epidemiologic and medical evidence, and by always clearly communicating the magnitude of the risk of adverse effects of sickle cell trait. [hematology.org]

The pathophysiology of renal abnormalities associated with sickle cell trait is described. The management of the primary clinical manifestations of this disorder, hematuria and papillary necrosis, are discussed. [ncbi.nlm.nih.gov]

· Presents new chapters on pathogenesis and pathophysiology of diabetic nephropathy and genetic basis of glomerular and structural kidney disorders.. · Provides expanded coverage of the pathophysiology and management of chronic kidney disease. [books.google.com]

The pathophysiology of renal abnormalities associated with sickle cell trait is described. The management of the primary clinical manifestations of this disorder, hematuria and papillary necrosis, are discussed. Cited By... [jasn.asnjournals.org]

In sickle cell, being dehydrated could lead to a crises, so preventing this is key. Having a diet rich in anti-oxidants can help prevent and reduce the inflammation and tissue damage associated with RPN. [sicklecellwarriors.com]

Prevention Analgesic toxicity can be prevented by limiting the availability of OTC analgesia. Particular attention should be given to monitoring the elderly. They are both more likely to need analgesia and more likely to use it. [patient.info]

As a means of preventing this disease greater control over analgescis is needed. [ncbi.nlm.nih.gov]

Prevention Control of diabetes or sickle cell anemia may reduce risk. Prevention of renal papillary necrosis from analgesic nephropathy includes careful moderation in the use of medications, including over-the-counter analgesics. [medical-dictionary-search-engines.com]