Secondary amyloidosis of the bladder causing macroscopic hematuria

Abstract

Bladder involvement in amyloidosis is unusual. The case of an 80-year-old man with macroscopic hematuria caused by secondary amyloidosis of the bladder is described. Cystoscopic examination revealed only a diffuse edematous area and bleeding. No tumor-like lesions were identified. Transurethral biopsy revealed amyloid deposits. Macroscopic hematuria disappeared spontaneously after cystoscopy and bladder biopsy. The patient has been followed up without treatment and is currently free of symptoms.

Spontaneous Massive Bladder Hematoma in the Late Period After Kidney Transplantation in Patients with AA Amyloidosis: Two Cases

“…Additionally, secondary bladder amyloidosis has a lower incidence than primary bladder amyloidosis. 7 In renal transplant recipients, macroscopic hematuria occurs with the prevelance of 12% after transplantation mostly because of infections, surgical complications, malignancies, graft rejections, recurrences of primary disease and calculus formation. 8 Although there is a case of secondary bladder amy-loidosis that presented itself with macroscopic hematuria in an FMF patient treated with renal transplantation, bladder hematoma or perforation without an obvious reason like trauma, clotting disorder, history of radiation or surgery is an extreme case and, to our knowledge, these are the very first cases with AA amyloidosis in renal transplant recipients.…”

Systemic amyloidosis presenting with lower urinary tract symptoms

“…Amyloidosis is characterized by the deposition of proteinaceous material in various tissues. Amyloidosis rarely affects the urinary bladder, 1 with few cases reported 2 . We present a patient with senile systemic amyloidosis who presented with lower urinary tract symptoms.…”

“…The most common types of amyloidosis are Amyloid Light Chain (AL) and Amyloid Associated (AA). AL amyloidosis is due to the deposition of protein subunits derived from immunoglobulin light chains 1,2 . It is a plasma cell dyscrasia and is often referred to as primary amyloidosis.…”

“…It is a plasma cell dyscrasia and is often referred to as primary amyloidosis. AA amyloidosis is due to fibrils derived from fragments of the acute phase reactant serum amyloid A and is often referred to as secondary amyloidosis 1,2 . It is associated with chronic diseases where inflammation is continual or flares, such as rheumatoid arthritis.…”

“…The cystoscopic appearance of amyloidosis is very variable. It has been described as areas of diffuse bleeding and oedema, fine red web‐like trabeculations, areas of ulceration, raised beefy lesions, fine bluish dots and as tumour‐like lesions 1,3 …”