{"title":"Nutcracker Syndrome and its Exceptional Occurrence with Pulmonary Tuberculosis: A Case Report.","authors":"Shiv Charan Jelia, Devendra Ajmera, Divya Airan, Yogesh Meena, Ranjeet Bairwa","doi":"10.59556/japi.72.0718","DOIUrl":null,"url":null,"abstract":"<p><p>Nutcracker syndrome (NCS), also known as left renal vein (LRV) entrapment syndrome, is a condition resulting due to compression of LRV between the aorta and superior mesenteric artery (SMA), with dilatation of the distal portion of LRV. We present a case of an elderly female presenting with left lumbar pain for 1 year. Initial investigations revealed microscopic hematuria and mild ascites. Further investigations revealed compression of LRV between the aorta and SMA, with aorto-SMA angle reduced up to 12°, suggesting a diagnosis of NCS. Along with this, cystic bronchiectasis with multiple centrilobular nodules with tree-in-bud pattern was seen in bilateral lung fields, suggestive of pulmonary tuberculosis. Ziehl-Neelsen (ZN) staining and cartridge-based nucleic acid amplification test (CBNAAT) confirmed our diagnosis of NCS with pulmonary tuberculosis.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"72 12","pages":"97-98"},"PeriodicalIF":0.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Journal of the Association of Physicians of India","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.59556/japi.72.0718","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Nutcracker syndrome (NCS), also known as left renal vein (LRV) entrapment syndrome, is a condition resulting due to compression of LRV between the aorta and superior mesenteric artery (SMA), with dilatation of the distal portion of LRV. We present a case of an elderly female presenting with left lumbar pain for 1 year. Initial investigations revealed microscopic hematuria and mild ascites. Further investigations revealed compression of LRV between the aorta and SMA, with aorto-SMA angle reduced up to 12°, suggesting a diagnosis of NCS. Along with this, cystic bronchiectasis with multiple centrilobular nodules with tree-in-bud pattern was seen in bilateral lung fields, suggestive of pulmonary tuberculosis. Ziehl-Neelsen (ZN) staining and cartridge-based nucleic acid amplification test (CBNAAT) confirmed our diagnosis of NCS with pulmonary tuberculosis.
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