Spontaneous Subcapsular Hematoma on a Transplanted Kidney

Korean Journal of Nephrology 2009;28(5):469-473.

Seung Woon Byun, M.D., Ji Young Lee, M.D., Jung Sik Park, M.D., and Su-Kil Park, M.D.

Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

증례 : 자발적 이식 신 피막하 혈종 1예

변승운, 이지영, 박정식, 박수길

울산대학교 의과대학 서울아산병원 신장내과

Abstract

A 41-year-old female was admitted for a subcapsular hematoma of her graft kidney six weeks after she underwent a kidney transplant. No report on subcapsular hematomas of graft kidneys has been published in Korea. Subcapsular hematoma of graft kidneys is one of a few very rare causes of bleeding. The clinical manifestations of subcapsular hematoma are the abrupt onset of flank pain or upper abdominal pain, nausea, anorexia, dizziness, and decrease in hemoglobin. If it is diagnosed late, it can result in renal insufficiency, hypovolemic shock, and even death. During the authors’ management of a subcapsular hematoma of a renal graft, pure red cell aplasia induced by the parvovirus B19 was found to coexist. Bone marrow suppression, immunosuppressants and other drugs, bleeding, iron deficiency, and renal graft function insufficiency can result in anemia after a kidney transplant. Even though pure red cell aplasia is a rare cause of anemia, it should not be forgotten that pure red cell aplasia induced by parvovirus B19 infection can cause anemia after a kidney transplant.

Key Words: Hematoma, Kidney transplantation, Pure red cell aplasia, Parvovirus B19