A rare case of hematuria / Um caso raro de hematúria

The infestation by Schistosoma haematobium is common in African countries and West Asia. Its chronic phase is characterized by the deposition of eggs of the parasite in various tissues of the body with inflammatory response, formation of granulomas and fibrosis. Often the disease affects the urinary tract, presenting with hematuria, and, in terminal stage, renal failure by urinary obstruction and bladder squamous neoplasia. Since chronic infection can lead to significant morbidity, its imperative that the doctors who serve this immigrant population become familiar with this disease. We present a case of an immigrant boy from Guinea-Bissau seen in consultation for monosymptomatic terminal hematuria. The diagnosis of urinary schistosomiasis was confirmed by parasitological examination of urine and the anatomopathological examination of bladder biopsies. After therapy with praziquantel, the patient was asymptomatic.

A infestação por Schistosoma haematobium é comum em países africanos e no oeste asiático. Sua fase crónica é caracterizada pela deposição de ovos do parasita em vários tecidos do organismo com resposta inflamatória, formação de granulomas e fibrose. Afecta frequentemente as vias urinárias, apresentando-se com hematúria, e, em fases terminais, com insuficiência renal por obstrução urinária e, em último caso, neoplasia escamosa da bexiga. Dado que a infecção crónica pode resultar em elevada morbilidade, é imperativo que os médicos que assistem essa população de imigrantes se familiarizem com tal doença. Apresentou-se aqui o caso clínico de uma criança natural da Guiné-Bissau observado em consulta de Nefrologia por hematúria terminal monossintomática. O diagnóstico de schistosomíase urinária foi confirmado por exame parasitológico da urina e pelo exame anatomopatológico das biópsias vesicais. Após terapêutica com praziquantel, o doente ficou assintomático.

A rare case of hematuria.

The infestation by Schistosoma haematobium is common in African countries and West Asia. Its chronic phase is characterized by the deposition of eggs of the parasite in various tissues of the body causing inflammatory response, formation of granulomas and fibrosis. The disease often affects the urinary tract, presenting with hematuria and, in the terminal stage, renal failure by urinary obstruction and bladder squamous neoplasia. Since chronic infection can lead to significant morbidity, it is imperative that the physicians who serve this immigrant population become familiar with this disease. A case of an immigrant boy from Guinea-Bissau seen in a Nephrology appointment for monosymptomatic terminal hematuria is presented. The diagnosis of urinary schistosomiasis was confirmed by parasitological examination of urine and the pathological examination of bladder biopsies. After therapy with praziquantel, the patient became asymptomatic.

Acquired-transient factor X deficiency in a teenager with extensive burns.

Acquired factor X deficiency is an extremely rare situation. It has shown to be associated with systemic amyloidosis, respiratory mycoplasma infection, factor X inhibitors, antiphospholipid antibodies, vitamin K deficiency/liver disease as well as the use of certain medications (meropenem, valproic acid). The pathogenesis and transient nature of this deficit remain poorly understood. The authors describe the case of a teenager hospitalised for extensive burns that developed active bleeding after removal of central venous catheter. He was diagnosed with transient factor X deficiency. Normalisation of coagulation status and factor X levels occurred spontaneously 10 days after the bleeding episode.