Özkan ÇİNİCİ, Mustafa TURGUT, Tuncer SUİÇER, Mustafa GÜMÜŞ, Yücel ALAYLAR, Büşra KARAHAN, Doğan Nasır BİNİCİ
The Journal of European Internal Medicine Professionals - 2026;4(3):119-121
Wunderlich syndrome (WS) is a rare, potentially life-threatening spontaneous renal or perirenal hemorrhage, usually caused by renal neoplasms or vascular disorders. Hemodialysis patients are at higher risk due to uremic platelet dysfunction, dialysis-related hemostatic abnormalities, and acquired cystic kidney disease, even without anticoagulants. We present a hemodialysis patient with massive retroperitoneal hemorrhage and concurrent brucellosis, without renal mass or vascular malformation, suggesting multifactorial pathogenesis. Brucellosis may have contributed via endothelial dysfunction, immune-mediated vasculitis, and inflammatory cytokines. WS should be considered in hemodialysis patients with acute anemia or flank pain. Early imaging, diagnosis, and infection management are essential to improve outcomes.
