Oral tranexamic acid as a novel treatment option for persistent haematuria in patients with sickle cell disease
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A 17-year-old Nigerian female (para 1 + 0) with sickle cell disease (genotype HbSS) presented to the emergency department in sickle crisis with a 4-day history of gross haematuria with clots. The crisis settled quickly but her haematuria continued unabated. Urine was sterile and serum creatinine was 52 mmol/L. This was her first episode of haematuria. She had no other relevant past medical or family history. For 14 days, the patient was treated with intravenous fluids, analgesia and repeated blood transfusion. She underwent a number of investigations during this time.
CT urography and angiography demonstrated bilateral papillary necrosis and thrombus within the bladder. Selective bilateral renal arteriogram showed four renal arteries but no vascular abnormality or active bleeding point. Cystoscopy was performed and thrombus was evacuated. Following administration of furosemide, a jet of blood coming from the left ureteric orifice was seen. Both ureters were catheterised...
KeywordsSickle Cell Disease Streptokinase Tranexamic Acid Ureteral Obstruction Aminocaproic Acid