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Early Evaluation of Hematuria in a Patient Receiving Anticoagulant Therapy and Detection of Malignancy
Author(s) -
Ripley Toni L.,
Havrda Dawn E.,
Blevins Steve,
Culkin Daniel
Publication year - 2004
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.24.16.1638.50949
Subject(s) - medicine , cystoscopy , urinalysis , microscopic hematuria , malignancy , bladder cancer , urinary system , urine cytology , gross hematuria , cancer , surgery , proteinuria , kidney
A 63‐year‐old Caucasian man had a painless episode of dark‐colored urine while taking warfarin 62.5 mg/week for lone atrial fibrillation in the presence of documented stable anticoagulation. Urinalysis revealed microscopic hematuria. Three weeks later, he had an episode of gross, painless hematuria. Thorough evaluation of the upper and lower urinary tract with renal ultrasound, intravenous pyelography, and cystoscopy revealed poorly differentiated, early‐stage, transitional cell carcinoma of the bladder. The patient was not aware of any exposure to carcinogens known to predispose to bladder cancer, nor was he a tobacco user. Early identification of the malignancy allowed for aggressive surgical intervention. Although this patient was considered low risk for the development of bladder cancer and was taking anticoagulants, the presence of hematuria was indicative of underlying pathology. Timely and thorough evaluation of hematuria in patients taking anticoagulants is necessary to identify and treat clinically important pathology.