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Year : 1999  |  Volume : 15  |  Issue : 1  |  Page : 45-46

Massive hematuria due to renal papillary necrosis.

Department of Urology, Christian Medical College & Hospital, Vellore

Correspondence Address:
G Gopalkrishnan
Department of Urology, Christian Medical College & Hospital, Vellore

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Source of Support: None, Conflict of Interest: None

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Renal papillary necrosis (RPN) is a recognised complication in many medical conditions like sickle cell hemoglobinopathy, diabetes, analgesic abuse, and gout. Massive hematuria due to RPN has been reported in patients with sickle cell trait(1) but has not been described in those with other medical conditions. Two diabetic (type 2) males presented for evaluation of severe hematuria. Both patients had renal insufficiency, moderate to severe proteinuria and radiographic features of papillary necrosis. Complete radiological evaluation including computerized axial tomography (CT) and digital substraction angiography (DSA) failed to identify the source of bleeding. Cystoscopy at the time of hematuria localised the bleeding to the left kidney. Flexible ureteroscopy subsequently confirmed the bleeding to occur from the midpole papilla in one and the lower pole papilla in another. The bleeding points were coagulated with a bugbee electrode. Massive hematuria due to papillary necrosis in type 2 diabetes has not been reported earlier in literature.

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