Case 767 -- A 79 year-old female with abdominal pain and bloody urine after dialysis session

Contributed by Richard Freij, MD


Serial hemolyzed samples of 79 year-old female with a complicated history of chronic disease including hemodialysis-dependent end-stage renal disease, status post recent ureteral stenting procedure for uretropelvic junction obstruction, atrial fibrillation, coronary artery disease, diabetes mellitus II, hypertension and hypothyroidism. At the end of the dialysis session she developed abdominal pain and passed bloody urine. She confirmed that this has been going on for a couple of weeks and the symptoms have been progressively worsening. She also had altered mental status. The clinician noted, "There have also been questions surrounding the validity of her blood draws from the emergency department where her labs appear to be hemolyzing serially, but the values are remaining essentially identical."

After 4 serial hemolyzed specimens, this hemolysis resolved spontaneously.


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