Misdiagnosis of loin pain hematuria syndrome as a somatization disorder

Abstract

Introduction

Loin pain hematuria syndrome (LPHS) is a rare kidney disease with a prevalence of −0.012%. Its clinical features include periods of severe uni-or bilateral lion pain, accompanied by (microscopic) hematuria. It is often misdiagnosed as a psychiatric condition, particularly under the heading of a somatization disorder.

Objectives

We describe the case of a patient who developed depressive symptoms after decades of suffering from severe intermittent bilateral loin pain.

Aims

To report a case-study, describing LPHS as a cause of severe chronic pain and persistent depressive symptoms.

Methods

A case-study is presented and discussed, followed by a literature review.

Results

A 55-year-female was referred to a psychiatrist for her depressive symptoms and persistent periods of severe unilateral or bilateral lion pain and intermittent hematuria for over 25 years. There she was diagnosed with a depression and somatization disorder. She received amitriptyline for many years, without any effect. Finally, the patient opted for a second opinion in an academic hospital in Belgium where it was quickly discovered. After surgery, including renal denervation and kidney autotransplantation, her somatic problems and depressive mood disappeared.

Conclusions

The awareness of LPHS is still very limited in medicine. This may lead to incorrect diagnoses, including psychiatric disorders such as somatization disorder. More awareness could lead to earlier diagnosis and prevent the consequences of severe debilitating pain.

Disclosure of interest

The authors have not supplied their declaration of competing interest.