본 증례는 저체중인 환자에서 수개월 이상의 육안적 혈뇨 및 소량의 단백뇨가 지속되어 시행한 조직 검사상 얇은기저막병이 확인되었으나 입원하여 추가적으로 시행한 영상 검사 및 방광경, 신 정맥 조영술, 도플러 초음파 상 호두까기 증후군이 동반된 것으로 최종적으로 확인되어 이에 문헌고찰과 함께 보고하는 바이다.
Nutcracker syndrome is caused by external compression of the left renal vein and is characterized by various symptoms, such as hematuria and left flank pain. However, long-standing gross hematuria is uncommon. We report the case of a 23-year-old woman who had had painless gross hematuria for several months. Kidney biopsy revealed thin basement membrane disease, but this did not explain the gross hematuria with proteinuria. Renal venography and Doppler ultrasonography showed increased diameter and velocity ratios between the left renal vein and inferior vena cava. Cystoscopy revealed that the hematuria originated from the left ureteral orifice. These results indicate coexisting Nutcracker syndrome. Nutcracker syndrome with thin basement membrane disease should be considered in the differential diagnosis of a patient who has long-standing gross hematuria.