Pyeloureteral filling defects associated with systemic anticoagulation: a case report

Area of Science:

• Urology
• Radiology
• Pathology

Background:

• Pyeloureteritis cystica is typically associated with chronic infection and inflammation.
• The exact etiology remains incompletely understood, with various theories proposed.

Observation:

• A unique case of pyeloureteritis cystica with acute onset and rapid radiographic resolution is presented.
• The patient showed no evidence of preceding or concurrent infection.
• The condition developed after initiating heparin therapy for suspected pelvic thrombophlebitis.

Findings:

• Radiographic findings of pyeloureteral filling defects resolved quickly after discontinuing heparin.
• This rapid resolution suggests an alternative etiology to chronic infection.

Implications:

• The rate of radiographic resolution may be a key factor in differentiating pyeloureteritis cystica from submucosal hemorrhage.
• This case highlights a potential drug-induced etiology for pyeloureteritis cystica, specifically related to heparin.
• Further investigation into heparin's role in pyeloureteritis cystica is warranted.