title: Frank hematuria as the presentation feature of acute leukemia.
abstract: Muco-cutaneous bleeding is a common presenting feature of acute leukemias. Mucosal bleeding usually manifests as gum bleeding and/or epistaxis but may occur in any mucosal surface of the body. Hematuria as an isolated or main presenting feature of acute leukemia is rare. We describe two cases of acute leukemia, a 19 year old male with acute lymphoblastic leukemia and a 52 year old male with acute myeloid leukemia, both presenting with gross hematuria. There was no demonstrable leukemic infiltration of the urinary tract on imaging studies. Hematuria in these patients was likely to be due to occult leukemic infiltration of the urinary system, aggravated by thrombocytopenia, as it subsided after starting chemotherapy. Our cases highlight that hematuria should be remembered as a rare presenting feature of acute leukemia.
authors.affiliation: Department of Accident and Emergency (Division of Hematology/Oncology), King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Owais M
authors.initials: OM
authors.lastname: Suriya
authors.forename: Aamer
authors.initials: A
authors.lastname: Aleem
mesh_terms: D001772:Blood Cell Count; D001856:Bone Marrow Examination; D017809:Fatal Outcome; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D013921:Thrombocytopenia / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult