Description
A 23 year old female with severe sickle cell disease was admitted with a short history of haematuria. This progressed following admission and eventually required 92 units of packed cells over 45 days. Investigations revealed no evidence of a bleeding diathesis; cystoscopy demonstrated bleeding from the left ureter. The haematuria continued unabated; attempted radiological intervention was unsuccessful. In view of the severity and protracted nature of the haematuria with failure of all conservative measures, recombinant activated factor VII was administered, hoping to utilise its potential as a universal haemostatic agent. Following treatment with rVIIa, the haematuria settled dramatically and eventually ceased following ureteroscopy and wash-out of clot from the left renal pelvis. Following discharge, she has had no further episodes of haematuria.
