Superselective embolization of vesical arteries for management of hemorrhagic cystitis caused by BK polyomavirus

Abstract

A 36 year- old male patient who had received an allogeneic stem cell transplanta- tion from a non- familial identical donor for the treatment of non- Hodgkin lymphoma 19 days ago admitted to the emergency de- partment with macroscopic hematuria. A BK virus induced hematuria was diagnosed and conservative measures failed to get his heamaturia under control.Hyperbaric oxygen therapy and Cidofovir treatment had also failed. Then bilateral percutaneous neph- rostomies were inserted followed by selec- tive angioembolization of vesical arteries one week later. Two weeks after angioembo- lization both nephrostomies were clamped sequentially and the patient was able to pass urine comfortably without any haematuria. Management of heamorrhagic cystitis by a stepwise, rapid multi-disciplinary approach can be a critical factor in the success of stem cell transplantation. 

Keywords

• ngioembolization,cystitis,hematuria,lymphoma,stem cell transplanta- tion

BK Virüse bağlı hemorajik sistitte süperselektif mesane arter embolizasyonu

Abstract

Otuz altı yaşında erkek hasta, non Hodg­kin lenfoma tanısıyla allojenik kök hücre nak­li sonrası 19. günde makroskopik hematüri ile başvurdu. Hematürinin BK virüse bağlı geliştiği saptandı. Konservatif yaklaşım ile hematüri kontrol altına alınamadı. Hiperba­rik oksijen tedavisi ve Sidofovir intravezikal tedavisi denendi ancak başarılı olmadı. Ta­kiben hastaya bilateral perkütan nefrostomi takılıp 1 hafta sonra kanayan mesane arterleri selektif olarak embolize edildi. İşlemden 2 hafta sonra nefrostomi klempe edildi, hasta­nın rahatlıkla idrar yaptığı ve hematürisinin olmadığı görüldü. Basamaklı hızlı multidi­sipliner yaklaşım ile hemorajik sistit yönetimi kök hücre nakli başarısı açısından da önem arz etmektedir.

Keywords

• anjiyoembolizasyon,hematüri,kök hücre nakli,lenfoma,sistit

References

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