Does this case hold the answer to one of the worse types of pain in medicine--that of loin pain haematuria syndrome (LPHS)

Article


Russell, Alan, Chatterjee, Suman and Seed, M. 2015. Does this case hold the answer to one of the worse types of pain in medicine--that of loin pain haematuria syndrome (LPHS). BMJ Case Reports. 2015 (apr26).
AuthorsRussell, Alan, Chatterjee, Suman and Seed, M.
Abstract

A patient with loin pain haematuria syndrome suffering chronic throbbing pulsing pain
overlaid with prolonged periods of incapacitating colic and overnight vomiting was
presented 10 months following diagnosis. Ultrasound was normal. No renal or ureteral
stones, or filling defects were seen on CT. At cytoscopy, bladder and urethra were normal,
and bloody urine effluxed from the left ureteric orifice. The ureters were normal at
diagnosis, and developed new abutting non‐penetrating calcifications by 8 months. Pain
episodes of complete incapacitating intensity of 2–4 h duration were reduced to 10 min
with 5 mg crushed tadalafil administered at onset. If tadalafil was delayed to after onset, the
original course of agony resulted. Daily tadalafil reduced loin pain intensity, but not the
exacerbations. Tadalafil efficacy may indicate that the pain exacerbations are due to spasm
of ureter smooth muscle. 5 mg tadalafil taken at onset alleviated severe loin pain
exacerbations in this case of loin pain haematuria syndrome.

JournalBMJ Case Reports
Journal citation2015 (apr26)
ISSN1757-790X
Year2015
PublisherBMJ
Accepted author manuscript
License
CC BY
Digital Object Identifier (DOI)doi:10.1136/bcr-2014-209165
Publication dates
Print26 Apr 2015
Publication process dates
Deposited01 Jun 2015
Accepted03 Apr 2015
Copyright information© 2015 BMJ
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https://repository.uel.ac.uk/item/85651

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