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Acquired hemophilia A (AHA) is an acquired bleeding disorder caused by neutralizing antibodies (inhibitors) against Coagulation Factor VIII (FVIII:C), causing sudden hemorrhagic symptoms (i.e., subcutaneous bleeding, intramuscular bleeding, and hematuria). Herein, this study is aimed at presenting a case of AHA diagnosed based on hematuria and reviewing patients who were diagnosed with AHA due to hematuria. A 67‐year‐old woman was referred to Atsugi City Hospital with painless gross hematuria that began 4 weeks before presentation. Contrast‐enhanced computed tomography (eCT) revealed an approximately 2 cm mass in the right renal pelvis, and the patient's activated partial thromboplastin time (APTT) was elevated (61.4 s). The day after the endoscopic biopsy, the patient was in shock due to a large retroperitoneal hematoma. Although her condition stabilized after intravenous radioembolization, she underwent emergency surgeries several times because of rebleeding within the next 3 weeks. At that time, APTT was more prolonged at 106.4 s, and the FVIII:C level was 2%. Mixing tests showed an upwardly convex curve after 2‐h incubation, indicating the presence of an inhibitor. Factor VIII inhibitor titer was ≥5.1 Bethesda unit (BU)/mL. A combined product of Plasma‐Derived Factors VIIa and X (pd‐FVIIa/FX), as second‐line hemostatic therapy, as well as cyclophosphamide (CYP), were administered after Recombinant Activated Factor VIIa (rFVIIa) had been ineffective. Following this, the Factor VIII inhibitor titer was undetectable, FVIII:C levels were restored, and APTT decreased to within the normal range. Gross hematuria was significantly alleviated. However, the patient died of cytomegalovirus and fungal infections due to prolonged immunosuppressive therapy. Although AHA diagnosed based on hematuria may have a better prognosis than others, there have been occasional cases with severe outcomes. APTT, detected upon initial hematological testing in patients with hematuria, may be a potential indicator of an existing AHA. [ABSTRACT FROM AUTHOR]

Post-infectious glomerulonephritis (PIGN) is an immune complex mediated glomerular injury occurring because of an infection, most commonly with group A beta-hemolytic streptococcus in children. C3 glomerulopathy (C3G) is a distinct clinicopathological entity occurring secondary to dysregulation of alternate complement pathway encompassing both C3 glomerulonephritis (C3GN) and dense deposit disease (DDD). While most patients with PIGN attain complete remission with normalized complement levels by 6–8 weeks after presentation, patients with C3G continue to have hypocomplementemia with high rates of progressive kidney disease. Here, we report a patient diagnosed with dense deposit disease after his initial presentation with PIGN three years prior. While current literature continues to explore the overlapping and distinguishing features of PIGN and C3G, including how underlying defects in the alternate complement pathway may commonly contribute to both diseases, this case further exemplifies the importance of recognizing the clinico-pathogenic features of PIGN and C3G in pediatric patients with glomerulonephritis. [ABSTRACT FROM AUTHOR]

Introduction: Benign prostatic hyperplasia is a prevalent disease that could be responsible of severe intractable hematuria requiring invasive surgical management. Case presentation: We report three high-risk cases presented with intractable hematuria of prostatic origin with high medical co-morbidities treated safely and effectively by prostatic artery embolization with favorable outcomes. Conclusions: In non-surgical, anticoagulated patients, prostatic artery embolization represents a safe and effective intervention for the treatment of intractable hematuria related to benign prostatic hyperplasia.

Eosinophilic cystitis (EC) is a rare inflammatory condition characterized by eosinophilic infiltration into the bladder wall. It often presents symptoms common to urological issues such as urinary tract infections, hematuria, bladder stones, or bladder neoplasms. Here, we describe a case of a 44-year-old male veteran with a history of multiple tuberculosis episodes who presented to the Emergency Department with dysuria, suprapubic pain, and gross hematuria.Initial imaging and cystoscopy concerned bladder neoplasia; however, subsequent pathological evaluation showed EC. This case underscores the importance of considering EC in the differential diagnosis of bladder tumors, especially when imaging describes bladder wall thickening in a patient without risk factors for bladder malignancy.

Ruptured renal artery aneurysms are uncommon. Although the increased use of endovascular technologies, controversy persists over the management. Contained rupture may be more difficult to diagnose, hence delay the management. We report a case of contained rupture of renal artery aneurysm treated with selective embolization prior to nephrectomy.

A man in his 70s suffered cardiac arrest, and his family initiated cardiopulmonary resuscitation after placing an emergency call. The initial waveform of the automated external defibrillator performed by emergency medical technicians revealed ventricular fibrillation. The patient received cardiovascular life support, including direct current countershock, and was transported to the hospital. Upon arrival, he underwent extracorporeal cardiopulmonary resuscitation using an automated chest compression device. Additionally, an intra-aortic balloon pumping was introduced after coronary angiography and percutaneous coronary intervention. Plain computed tomography images revealed leakage of the contrast medium used during coronary angiography in the bilateral renal pelvis and perirenal area as well as bladder retention. Furthermore, a urine test revealed gross hematuria. There were no findings of prostatic hypertrophy or urinary tract disease. Based on the patient's clinical course, injury caused by chest compression was the most likely etiology of urinary tract injury, which must be considered in such patients. The patient was discharged with cerebral performance category 1, without any complication except urinary tract., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Tada et al.)

Scrub typhus is caused by Orientia tsutsugamushi , a Gram-negative coccobacillus. It comprises three strains: Karp, Gilliam, and Kato. Cases of scrub typhus are usually found in the Asia-Pacific region, and their presentation may range from minimal symptoms to multi-organ involvement, with or without the presence of an eschar mark. Varying manifestations of scrub typhus, such as gangrene, meningoencephalitis, anemia with jaundice, and hematuria, have been observed. In the Kumaun region of northern India, there has been a surge in the number of scrub typhus cases. Typically, this disease is accompanied by an eschar mark, but occasionally it can manifest without one. We report a series of four cases presenting with various unusual symptoms such as gangrene of the limbs, meningoencephalitis, jaundice, and hematuria. Serology for scrub typhus should be considered in all patients with acute febrile illness not responding to treatment, especially in mountainous regions, to prevent the associated mortality., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Saini et al.)

Background and Objective: Assessment of patients with hematuria (aH) remains a challenge in urological practice, balancing the benefits of diagnosing a potentially underlying bladder cancer (UCa) against the risks of possibly unnecessary diagnostic interventions. This study analyzes the potential of an mRNA-based urine assay, the Xpert ® Bladder Cancer Detection- CE-IVD (Xpert BC-D), in patients with hematuria., Materials and Methods: Overall, 368 patients with newly observed painless hematuria and no history of UCa were included in this observational study. Patients received urological workup, including urethrocystoscopy (WLC), upper tract imaging, urine cytology and Xpert BC-D. Patients with positive WLC were recommended to undergo tumor resection (TUR-B)., Results: After excluding non-assessable cases, 324 patients were considered for analysis (188 males, 136 females; median age: 61 years). Eight of twenty-eight patients with a positive TUR-B had Ta low grade (LG) tumors; the others were diagnosed with high grade (HG) lesions (Ta: 4, CIS: 2, T1:11, > T1:3). The Xpert BC-D was more sensitive than urine cytology (96% vs. 61%) ( p  = 0.002). Increased risk ratios (RR) were observed for gross hematuria, gender, urine cytology, and positive Xpert BC-D (all p  < 0.05). Age and positive Xpert BC-D remained independent predictors of UCa in multivariate analysis. Simulating a triage with WLC restricted to patients with positive Xpert BC-D could have saved 240 (74.1%) assessments at the cost of missing one pTa LG tumor., Conclusions: The results suggest a potential role for Xpert BC-D in preselecting patients with hematuria for either further invasive diagnosis or an alternate diagnostic procedure., Competing Interests: BJSD is consultant, speaker and trialist for Cepheid, Sunnyvale, CA, USA, and Nucleix, Rehovot, Israel/USA and trialist for Concile, Freiburg, Germany, Zetiq/NextAge, Tel Aviv, Israel, and Arquer Diagnostics Ltd, Sunderland, UK. PJG is consultant and trialist for Cepheid, PB, JC, EP, and MB are employees of Cepheid, Sunnyvale, CA, USA BJSD and PJG are members of the Bladder Cancer Editorial Board, (© 2024 – The authors. Published by IOS Press.)