Wunderlich Syndrome in a Hemodialysis Patient with Concomitant Brucellosis: A Multifactorial Hemorrhagic Interaction
Wunderlich Syndrome in Brucellosis
DOI:
https://doi.org/10.5281/zenodo.21787633Keywords:
Brucellosis, Renal Dialysis, Retroperitoneal Hematoma, Spontaneous Renal Hemorrhage, Wunderlich SyndromeAbstract
Wunderlich syndrome (WS) is a rare, potentially life-threatening spontaneous renal or perirenal hemorrhage, usually caused by renal neoplasms or vascular disorders. Hemodialysis patients are at higher risk due to uremic platelet dysfunction, dialysis-related hemostatic abnormalities, and acquired cystic kidney disease, even without anticoagulants. We present a hemodialysis patient with massive retroperitoneal hemorrhage and concurrent brucellosis, without renal mass or vascular malformation, suggesting multifactorial pathogenesis. Brucellosis may have contributed via endothelial dysfunction, immune-mediated vasculitis, and inflammatory cytokines. WS should be considered in hemodialysis patients with acute anemia or flank pain. Early imaging, diagnosis, and infection management are essential to improve outcomes.
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Copyright (c) 2026 Özkan Çinici, Mustafa Turgut, Tuncer Suiçer, Mustafa Gümüş, Yücel Alaylar, Büşra Karahan, Doğan Nasır Binici
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