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+A 69 year old woman with a personal history of chronic renal failure (CRF) without affiliation, rheumatoid arthritis (RA) of 20 years' evolution, on chronic treatment with corticoids. The patient presented with a sudden onset of total anaemic haematuria, haemodynamic compromise, accompanied by significant deterioration of renal function (creatinine 6.9); after orthopaedic knee surgery. The urological ultrasound scan showed normal kidneys, with no alterations in the parenchyma or collecting system; a large bladder clot was observed.
+After failure of conservative management with saline solution, the patient presented haemodynamic destabilisation, and endoscopic exploration was performed, but it was impossible to extract the clot; given the situation, open surgery was decided, opening the bladder, extracting the clot, and the bladder mucosa was found to be thinned with bleeding in a sheet, with no macroscopic bladder lesions. Random biopsies of the bladder mucosa were taken and reported as bladder amyloidosis with extensive vessel involvement. Treatment with perfused corticosteroids and colchicine. The patient was discharged without haematuria and renal function improved (creatinine 2.3).
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