Li Chen, Wang Yu-Wei, Sheng Han, Jin Di, Shu Zi-Xuan, Li Ming, Li Sheng-Guang
Department of Dermatology, Tianjin Institute of Integrative Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China.
Department of Rheumatology, Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, China.
Int J Rheum Dis. 2025 Mar;28(3):e70190. doi: 10.1111/1756-185X.70190.
Nutcracker syndrome (NCS) is a rare vascular disorder characterized by compression of the left renal vein, typically causing hematuria, proteinuria, and flank pain. Although NCS is often linked with weight loss and anatomical variations, no previous reports have connected it to systemic lupus erythematosus (SLE). We describe a 44-year-old male with SLE who developed NCS after rapid weight loss, presenting with abdominal pain, hematuria, and proteinuria. Imaging confirmed left renal vein compression between the aorta and the superior mesenteric artery. This finding suggests that significant weight reduction in SLE may trigger NCS by altering retroperitoneal fat and vascular structures. A literature review reveals a consistent association between NCS and marked weight loss, as well as possible coexistence with other vascular compression syndromes, such as superior mesenteric artery syndrome. Clinicians should consider NCS in SLE patients with sudden weight changes to ensure timely diagnosis and prevent complications.
胡桃夹综合征（NCS）是一种罕见的血管疾病，其特征为左肾静脉受压，通常会导致血尿、蛋白尿和侧腹痛。虽然NCS常与体重减轻和解剖变异有关，但此前尚无将其与系统性红斑狼疮（SLE）相关联的报道。我们报告一例44岁患SLE的男性患者，其在快速减重后发生NCS，表现为腹痛、血尿和蛋白尿。影像学检查证实腹主动脉与肠系膜上动脉之间存在左肾静脉受压。这一发现提示，SLE患者体重显著减轻可能通过改变腹膜后脂肪和血管结构而引发NCS。文献综述显示，NCS与显著体重减轻之间存在一致关联，且可能与其他血管压迫综合征（如肠系膜上动脉综合征）共存。临床医生应对体重突然改变的SLE患者考虑NCS的可能，以确保及时诊断并预防并发症。
