[Renal subcapsular hematoma developed with an elderly myelodysplastic syndrome case]

An 82-year old, elderly woman who had been found to have myelodysplastic syndrome (MDS)-refractory anemia three years previously, complained of fever and abdominal pain, and was hospitalized. Abdominal CT images resulted in a diagnosis of renal subcapsular hematoma thus conservative treatment, including blood transfusions of platelet, was initiated. However, the hematoma enlarged, and she also had a spiking fever. After the hematoma was punctured and we drained an abscess caused by Klebsiella Pneumoniae, the hematomal legion subsided, and the inflammatory symptoms improved. There has been no recurrence for more than one year. This case is thought to be the first in which a renal subcapsular hematoma developed with MDS. Although the cause of the renal subcapsular hematoma has not yet been identified, the vulnerability due to aging of the small vessels along with a decrease in the number of platelets have been considered as contributing factors in this elderly case.