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.