- CASE FILE
My 28yo wife has gross hematuria w/ clots. 45 days, 3 hospital transfers and 10u of blood so far but no one can find the source of bleeding.
ABOUT THIS CASE FILE
At the end of may my 28 year old wife complained she thought she might have a kidney infection. I believe it was just some minor flank pain, urgency, frequency, maybe some burning. On 5/30 or 31 she got hit in the left side trying to teach our friends 12 yo autistic kid to play baseball. He didnt mean it so she didnt make a big deal about it. By the time she made the 8 hr trip back home from their visit with them in Texas she was pale, diaphoretic, and trying not to breathe due to the left flank pain. She says she had already been peeing blood a bit for a week beforehand and she was retaining around 600 ml of urine that was trapped by clots if I remember right. Since then she hasnt stopped bleeding. She has been tossed around 3 hospitals (Hillcrest south, Hillcrest, saint Francis and soon to be OU medical) and gets 2 units of blood about once a week but sometimes less than a week . Yesterday before her transfusion her hgb was 5.5 her BP was 102/92 and if she attempted to move her HR shot up in the 180's.
She had something similar happen in September. She felt like she had a mild infection, then lost a UFC fight and a few days later ended up in the emergency room thinking she had kidney stones but it was just gross hematuria was clots. She was in there around 2 weeks I think, they couldnt figure it out, everyone got frustrated and agreed she should just follow up outpatient and they discharged her. She struggled about a week eith peeing and pain but then started peeing again. That time wasnt near as bad and she never needed blood.
This time she has seen hematology, urology, and nephrology plus had about 5 cystoscopies, 2 arteriograms, a bladder biopsy, a kidney biopsy, multiple CT's, ultrasounds,a ureteroscopy, 3 weeks worth of continuous bladder irrigation using imcar(sp?) and antibiotics at times in the infusion, she has had up to a 24 French catheter to help pass the clots, 2 stents in her ureters... we just need answers. She's losing hope and everyone is at a loss. Everyone can see evidence of bleeding inside and out but no one can find where it's coming from. Her renal blood tests are perfect last I saw. Sometimes with cystoscopies or cbi they can clear it up temporarily but the bleeding always comes back with a fury. They pulled a clot the size of a softball out of her bladder last week. Now she's about to be an hour and a half away from home with no idea what the next steps might be. Please help her.