Spontaneous Perirenal Hemorrhage in Patient with Antiphospholipid Syndrome

Case Report

Authors

  • William Adipurnama Department of Urology, Primaya PGI Cikini Hospital, Jakarta, Indonesia
  • Jacinda Risha Oktaviani Department of Urology, Primaya PGI Cikini Hospital, Jakarta, Indonesia
  • Nicholas Andrian Singgih Department of Urology, Primaya PGI Cikini Hospital, Jakarta, Indonesia
  • Cecilia Noviyanti Salim Department of Urology, Primaya PGI Cikini Hospital, Jakarta, Indonesia
  • Derry Wendians Suhanto 1Department of Urology, Primaya PGI Cikini Hospital, Jakarta, Indonesia
  • Egi Edward Manuputty Department of Radiology, Primaya PGI Cikini Hospital, Jakarta, Indonesia
  • Budiawan Atmadja Department of Radiology, Primaya PGI Cikini Hospital, Jakarta, Indonesia

DOI:

https://doi.org/10.55175/cdk.v52i7.1353

Keywords:

Anticoagulant, antiphospholipid syndrome, spontaneous perirenal hemorrhage, Wunderlich syndrome

Abstract

Introduction: Spontaneous perirenal hemorrhage (SPH), also known as Wunderlich syndrome, is a rare condition that can potentially progress into life-threatening non-traumatic retroperitoneal hemorrhage. Common symptoms include acute flank or abdominal pain, a palpable flank mass, and fulminant hypovolemia, collectively referred to as Lenk’s triad, and diagnosis is typically established radiologically using a CT scan. Antiphospholipid syndrome (APS) - a rare, immune-mediated hypercoagulable disorder that occurs in only 5 cases per 100,000 people per year worldwide. It is immune-mediated, characterized by persistent antiphospholipid antibodies (APLA) that cause both arteries and venous thrombosis, and can present as peripheral arterial disease (PAD), acute arterial occlusion, and early atherosclerosis. Case : A 33-year-old woman with chronic kidney disease (CKD) presented with SPH and incidentally diagnosed with peripheral arterial disease (PAD) and APS. Conclusion : Conservative management was beneficial for SPH without the need for surgical intervention; however, antithrombotic therapy for PAD posed additional challenges before the patient was eventually discharged in improved condition for outpatient follow-up.

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Published

07-07-2025

How to Cite

Adipurnama, W., Oktaviani, J. R., Singgih, N. A., Salim, C. N., Derry Wendians Suhanto, Manuputty, E. E., & Budiawan Atmadja. (2025). Spontaneous Perirenal Hemorrhage in Patient with Antiphospholipid Syndrome: Case Report. Cermin Dunia Kedokteran, 52(7), 475–479. https://doi.org/10.55175/cdk.v52i7.1353