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Bilateral renal haematuria and obstructive renal failure from acquired haemophilia A: a medical cause for a surgical problem
  1. Aiyapa Ajjikuttira1,
  2. Pranav Sharma1,2 and
  3. Handoo Rhee1
  1. 1Department of Urology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  2. 2Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
  1. Correspondence to Dr Aiyapa Ajjikuttira; aiyapa.ajjikuttira{at}


A 55-year-old male presented to our emergency department with haematuria and abdominal pain. Investigations including a computed tomography (CT) scan revealed an intraluminal filling defect within the left collecting system, consistent in appearance with blood clot. With an initial working diagnosis of upper tract urothelial cell carcinoma, he was discharged with plans for an urgent cystoscopy and ureteroscopy. He subsequently represented with ongoing frank haematuria, anasarca, dropping haemoglobin and new right collecting system blood clot. Subsequent investigations showed that the patient had acquired haemophilia A resulting in the episodes of haematuria, highlighted after an elevated activated partial thromboplastic time prompted a thrombophilia screen. The patient was subsequently treated with factor eight inhibitor bypass activity, corticosteroids and cyclophosphamide.

  • haematuria
  • urology
  • haematology (incl blood transfusion)

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  • Contributors AA was responsible for patient care, preparation and proofreading of the manuscript. PS was responsible for preparation and proofreading of the manuscript. HR was responsible for patient care and proofreading of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.