Hematuria unrelated to hemophilia in a hemophiliac

Whereas painless gross hematuria in the hemophiliac is usually secondary to the basic coagulation defect, it is not always so. An elderly man presented with this clinical situation which, after a protracted course, was ultimately proven to be associated with an infarcted kidney. In retrospect, the patient's age and the presence of an abdominal aortic aneurysm were clues that we were not dealing with hemophilic hematuria.