Bladder involvement in systemic amyloidosis causing massive hemorrhage in hemodialysis

Area of Science:

• Nephrology
• Urology
• Pathology

Background:

• Secondary amyloidosis is a systemic inflammatory condition.
• Chronic hemodialysis is a life-sustaining treatment for end-stage renal disease.
• Bladder involvement in amyloidosis is rare, especially in dialysis patients.

Observation:

• A patient on chronic hemodialysis presented with isolated hematuria.
• The hematuria rapidly progressed to massive hemorrhage.
• The patient experienced a spontaneous vesical (bladder) rupture.

Findings:

• The bladder rupture was attributed to secondary amyloidosis.
• This represents the first reported case of bladder amyloidosis in a patient undergoing hemodialysis.
• Amyloid deposition in the bladder wall weakened its structure, leading to rupture.

Implications:

• This case expands the understanding of secondary amyloidosis complications in dialysis patients.
• Early recognition of hematuria in dialysis patients may be crucial for detecting bladder amyloidosis.
• Managing hematuria in dialysis patients should consider rare but severe causes like amyloidosis.