Vasovagal Pseudohemorrhage Complication of Percutaneous Renal Biopsy

Abstract

PERCUTANEOUS renal biopsy is associated with a low risk of morbidity and mortality when precise localization techniques are used.1,2Nonetheless, a small number of patients will have complications from percutaneous renal biopsy.2,3One of the most serious complications is biopsyrelated bleeding requiring surgical intervention. The present report describes a patient who was initially considered to have hemorrhagic complications from a percutaneous biopsy but probably presented this clinical picture through the circumstantial interaction of diverse events. Report of a Case A 22-year-old woman with systemic lupus erythematosus was admitted to the University of Virginia Hospital for a percutaneous renal biopsy. The physical examination was essentially unremarkable. Her weight was 46.3 kg; blood pressure, 130/90 mm Hg; and pulse, 73 beats per minute. The creatinine clearance was 80 ml/min; quantitative urinary protein level, 6 gm/24 hr; hematocrit reading, 29%; platelet count, 197,000/cu mm; fibrinogen, 500 mg/100 ml; prothrombin time, 12.0/