Acquired Hemophilia presenting as Gross Hematuria following Kidney Stone – A Case Report and Review of the Literature

Vol. 44 (2): 390-392, March – Abril, 2018

doi: 10.1590/S1677-5538.IBJU.2017.0172

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

ABSTRACT

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]

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