An 18-year-old male was hospitalized for persistent hematuria for two months.
She had no relevant personal history (non-ureteral colic, no urinary or upper respiratory tract infections, no intake of nephrotoxic drugs, and no history of abdominal surgery or trauma), or family history of kidney disease.
Physical examination was strictly normal.
The initial tests that included systematic, biochemical and blood coagulation were normal.
The systematic urine revealed abundant erythrocytes per high-power field with protein excretion between 0.5 and 1 g/dl. Urinary cytology was negative for malignancy and cystoscopy showed bleeding from the left ureter.
Antinuclear antibodies, anti-DNA and anti-neutrophil cytoplasmic antibodies (ANCA) were negative.
Serum levels of IgA, IgG and IgM, complement concentration, sedimentation rate, ASLO and rheumatoid factor were normal, as well as abdominal ultrasound, intravenous urography and arteriography.
Computed tomography showed compression of the left renal vein by pinzanu dilatation of the venomous vein and a left renal vein with a pressure gradient between the left renal vein and the inferior vena cava.
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Subsequently, rigid and flexible bronchoscopy with an infusion pump was performed, applying a hyperpressure of the urinary tract.
After twelve months of follow-up the patient has not presented episodes of macroscopic or microscopic hematuria.
