Vol. 43 (x): 2017 August 8.[Ahead of print]
CHALLENGING CLINICAL CASES
Max Schmidt-Bowman 1, Lael Reinstatler 2, Eric P. Raffin 2, Joseph E. Yared 2, John D. Seigne 2, Einar F. Sverrisson 2
1 Geisel School of Medicine at Dartmouth, Hanover, NH; 2 Department of Surgery, Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH
A rare condition in itself, acquired hemophilia A, seldom presents as isolated gross hematuria. It is a serious condition with a high mortality rate and thus clinical suspicion followed by prompt diagnosis is imperative (1). In fact, only 8 cases of such presentation of this condition have been reported thus far in the literature. Of these, none describe the initial presentation of hematuria with the inciting event of a kidney stone. We present a case of a 67-year-old man with signs and symptoms of nephrolithiasis accompanied by profuse hematuria, who was subsequently found to have developed expression of factor VIII inhibitor leading to acquired hemophilia A.
Keywords: Hematuria; Nephrolithiasis; Factor 8 deficiency, acquired [Supplementary Concept]