title: Gross hematuria as a sign of acute rejection.
abstract: In the contemporary era of potent immunosuppressive regimens, previously encountered signs of renal allograft rejection such as fever and hematuria are rarely encountered. We report a teenager with severe recurrent acute humoral and cellular rejection whose presenting feature was gross hematuria with the presence of blood clots in the urine. We want to highlight that severe rejection even in the setting of modern immunosuppressive drugs can present as gross hematuria. Contrary to conventional wisdom that gross hematuria with the presence of blood clots in the urine is indicative of pathology in the renal collecting system, a parenchymal disease process should also be considered in renal transplant recipients.
authors.affiliation: Department of Pediatrics, University of California Davis Medical Center, Sacramento, CA, USA.
authors.forename: Erica
authors.initials: E
authors.lastname: Winnicki
authors.forename: Stephanie
authors.initials: S
authors.lastname: Nguyen
authors.forename: Lavjay
authors.initials: L
authors.lastname: Butani
mesh_terms: D000293:Adolescent; D005260:Female; D006084:Graft Rejection / Q000150:complications / Q000175:diagnosis* / Q000652:urine; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D016030:Kidney Transplantation; D012008:Recurrence
keywords: hematuria; kidney transplantation; rejection