{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T10:58:49Z","timestamp":1740135529511,"version":"3.37.3"},"reference-count":4,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Urol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Nephrocalcinosis is often asymptomatic but can manifest with renal colic or hematuria. There is no reported association between nephrocalcinosis and renal vascular malformations, which may also be a source of hematuria. We herein present a case of a patient with hematuria related to nephrocalcinosis and renal papillary varicosities. These varicosities were diagnosed and successfully treated with flexible ureteroscopy and laser fulguration.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 24-year-old female with a history of epilepsy (on zonisamide), recent uncomplicated pregnancy, and new diagnosis of nephrocalcinosis presented with right flank pain and intermittent gross hematuria. Imaging revealed intermittent right sided hydronephrosis. A cystoscopy identified hematuria from the right ureteral orifice. Diagnostic flexible ureteroscopy revealed numerous intrapapillary renal stones and varicose veins of several renal papillae. A 200\u00a0\u03bcm holmium laser fiber was used to unroof these stones and fulgurate the varicosities with resolution of her symptoms for several months. She later presented with left-sided symptoms and underwent left ureteroscopy with similar findings and identical successful treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Unilateral hematuria from discrete vascular lesions of the renal collecting system may be obscured by other benign co-existing conditions, such as nephrocalcinosis and nephrolithiasis. Although a simultaneous presentation is rare, flexible ureteroscopy with laser fulguration offers an ideal diagnostic and therapeutic modality for these concurrent conditions if symptoms arise.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12894-021-00931-3","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T12:02:49Z","timestamp":1638187369000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Symptomatic renal papillary varicosities and medullary nephrocalcinosis"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7563-8741","authenticated-orcid":false,"given":"Brent","family":"Cleveland","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Borofsky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,11,29]]},"reference":[{"key":"931_CR1","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1152\/ajprenal.00211.2016","volume":"311","author":"B Oliveira","year":"2016","unstructured":"Oliveira B, Kleta R, Bockenhauer D, et al. Genetic, pathophysiological, and clinical aspects of nephrocalcinosis. Am J Physiol Renal Physiol. 2016;311:1243\u201352.","journal-title":"Am J Physiol Renal Physiol"},{"issue":"1","key":"931_CR2","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1089\/end.2016.0747","volume":"31","author":"R Tanimoto","year":"2017","unstructured":"Tanimoto R, Kumon H, Bagley DH. Development of endoscopic diagnosis and treatment for chronic unilateral hematuria: 35 years experience. J Endourol. 2017;31(1):76\u201380.","journal-title":"J Endourol"},{"key":"931_CR3","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1111\/head.12480","volume":"55","author":"YI Jion","year":"2015","unstructured":"Jion YI, Raff A, Grosberg BM, et al. The risk and management of kidney stones from the use of topiramate and zonisamide in migraine and idiopathic intracranial hypertension. Headache. 2015;55:161\u20136.","journal-title":"Headache"},{"issue":"3","key":"931_CR4","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1053\/j.ackd.2013.01.012","volume":"20","author":"KL Cheung","year":"2013","unstructured":"Cheung KL, Lafayette RA. Renal physiology of pregnancy. Adv Chronic Kidney Dis. 2013;20(3):209\u201314.","journal-title":"Adv Chronic Kidney Dis"}],"container-title":["BMC Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12894-021-00931-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12894-021-00931-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12894-021-00931-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T12:05:52Z","timestamp":1638187552000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcurol.biomedcentral.com\/articles\/10.1186\/s12894-021-00931-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,29]]},"references-count":4,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["931"],"URL":"https:\/\/doi.org\/10.1186\/s12894-021-00931-3","relation":{},"ISSN":["1471-2490"],"issn-type":[{"type":"electronic","value":"1471-2490"}],"subject":[],"published":{"date-parts":[[2021,11,29]]},"assertion":[{"value":"27 October 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written consent was obtained from the patient for publication of this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Brent Cleveland\u2014none; Michael Borofsky\u2014paid consultant for Boston Scientific and Auris Health. Member of the data safety and monitoring board for Urotronic.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"164"}}