We read with great interest the contribution by Waseem et al. [6]. They reported a 17-year-old boy who presented with left flank pain and hematuria and was diagnosed with nutcracker syndrome (NCS) by computed tomography (CT). They also concluded that NCS is a rare but important and potentially treatable clinical condition and its early diagnosis with a high index of suspicion can achieve efficient management. Agreeing to their opinion, however, we would like to add a few comments on their conclusions. Above all, NCS is really not a rare entity but an underestimated or underrecognized cause of hematuria in children [3]. One of our authors previously reported that NCS was present in 60 (40 %) of the 149 children in whom no other explanation for hematuria was ascertained [5].
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