[Pyelocalyceal submucosal hemorrhage in a child treated with oral anticoagulants]

A 15 1/2-year-old girl with disseminated lupus erythematosus presented with acute flank pain and hematuria during oral anticoagulant therapy for thrombophlebitis of the lower extremities. The intravenous pyelogram demonstrated multiple filling defects of the renal collecting system interpreted as pyelocalyceal submocosal hemorrhage. This benign complication disappeared following adjustment of the anticoagulant therapy. An identical appearance has been described in a case of aplastic anemia, Henoch-Schonlein purpupa, and in renal truma. Submocosal hemorrhage of the renal collecting system is to be differentiated from pyeloureteritis cystca, uroepithelial tumor, vascular impressions from collateral circulation and submucosal edema.