PATHOLOGY OF INTRA-RENAL VASCULAR-LESIONS ASSOCIATED WITH THE LOIN-PAIN-HEMATURIA SYNDROME

The histological appearances of the proximal and peripheral intrarenal arteries and renal cortex were examined in 3 patients who underwent nephrectomy for intractable pain associated with the loin-pain-hematuria syndrome. Marked atherosclerotic changes were noted to involve segmental, lobar, interlobar and arcuate arteries with evidence in 1 kidney of early microaneurysmal formation. These lesions of the more proximal intrarenal arteries were associated with occlusive lesions of the interlobular arteries, areas of cortical ischemia and cortical infarcts consistent with the changes resulting from microemboli. The histological appearances correlated well with previously described angiographic findings.