Nephroptosis in a young woman with joint laxity.

BACKGROUND

A 25-year-old woman was evaluated repeatedly from 10 months following her first pregnancy and delivery for recurrent episodes of lower right quadrant abdominal pain, hematuria and a sensation of mass. Despite investigations by several physicians over a 7 month period no clear diagnosis had been made, but a psychosomatic disorder or possible periodic blocked bowel had been suggested, after which the patient requested a consultation with a nephrologist. Her history indicated joint laxity syndrome and a mitral valve prolapse. She was undergoing continuing evaluation for a possible rheumatic condition.

INVESTIGATIONS

Full history, physical examination, and intravenous pyelography.

DIAGNOSIS

Nephroptosis of the right kidney.

INTERVENTION

Exercises were prescribed to strengthen her abdominal musculature and she was advised to wear an elastic abdominal corset during the daytime. The patient is currently considering surgical intervention.