title: Spontaneous perinephric hematoma due to acquired factor X deficiency in AL amyloidosis.
abstract: Spontaneous perinephric hematoma (SPH) is a rare entity whose diagnosis is challenging because of its varied clinical presentation and lack of any specific etiology. We report a 34-year-old African-American male who presented with left flank pain and was found to have a large left perinephric hematoma, in the setting of undiagnosed AL amylodosis. The case illustrates that while a SPH due to the vascular angiopathy of amyloid is rare, when amyloidosis is associated with abnormal coagulation studies or bleeding at multiple sites, it should be considered because of its protean systemic manifestations and potential response to chemotherapy.
authors.affiliation: Department of Nephrology and Hypertension, Glickman Urology and Kidney Institute at Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Rupesh
authors.initials: R
authors.lastname: Raina
authors.affiliation: Department of Nephrology and Hypertension, Glickman Urology and Kidney Institute at Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Vidya
authors.initials: V
authors.lastname: Nadig
authors.affiliation: Department of Nephrology and Hypertension, Glickman Urology and Kidney Institute at Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Deven
authors.initials: D
authors.lastname: Patel
authors.affiliation: Department of Hematologic Oncology and Blood Disorders at Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Armin
authors.initials: A
authors.lastname: Jegalian
authors.affiliation: Department of Hematologic Oncology and Blood Disorders at Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Bernard
authors.initials: B
authors.lastname: Silver
authors.affiliation: Department of Nephrology and Hypertension, Glickman Urology and Kidney Institute at Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Heyka
keywords: amyloidosis; spontaneous perinephric hematoma