Recurrent Wunderlich syndrome in systemic lupus erythematosus: a case report
Dublin Core
Title
Recurrent Wunderlich syndrome in systemic lupus erythematosus: a case report
Subject
Wunderlich syndrome, Spontaneous renal hemorrhage, Connective tissue disease, Systemic lupus
erythematosus, Transcatheter arterial embolization
erythematosus, Transcatheter arterial embolization
Description
Abstract
Background Wunderlich syndrome (WS) is a rare condition characterized by spontaneous renal hemorrhage in the
absence of obvious trauma or iatrogenic injury. Given that most WS cases are life-threatening and require prompt
intervention, timely identification and resolution are essential. Patients with connective tissue diseases (CTDs) account
for a small proportion of reported WS cases; however, owing to the specific pathogenic mechanisms and treatments
associated with CTDs, these patients exhibit distinctive pathological traits and clinical features in WS.
Case presentation We present the identification and treatment process of WS in a patient with systemic lupus
erythematosus. This patient suffered from sudden abdominal pain and a drastic decline in hemoglobin level
accompanied by confusion of consciousness. After the abdominal computerized tomography scan revealed the
presence of a renal hematoma, transcatheter arterial embolization was performed on her. Unexpectedly, three days
later, the patient had severe anemia and consciousness disorders again. Highly suspecting renal rebleeding, we
performed a repeated angiography for the patient. After confirming the bleeding, embolization was carried out
again. The renal bleeding stopped, and the patient’s hemoglobin level gradually stabilized. Regrettably, this patient
ultimately died due to multiple systemic infections.
Conclusions WS that occurs in CTDs can evolve into critical and severe conditions. Infection, immune complex
deposition, thrombocytopenia, abnormal coagulation function, complement activation, autoantibodies production,
and glucocorticoid treatment in patients with CTDs are potentially linked to the development of WS. The treatment
strategies for WS should be guided by hemodynamic status.
Keywords Wunderlich syndrome, Spontaneous renal hemorrhage, Connective tissue disease, Systemic lupus
erythematosus, Transcatheter arterial embolization
Background Wunderlich syndrome (WS) is a rare condition characterized by spontaneous renal hemorrhage in the
absence of obvious trauma or iatrogenic injury. Given that most WS cases are life-threatening and require prompt
intervention, timely identification and resolution are essential. Patients with connective tissue diseases (CTDs) account
for a small proportion of reported WS cases; however, owing to the specific pathogenic mechanisms and treatments
associated with CTDs, these patients exhibit distinctive pathological traits and clinical features in WS.
Case presentation We present the identification and treatment process of WS in a patient with systemic lupus
erythematosus. This patient suffered from sudden abdominal pain and a drastic decline in hemoglobin level
accompanied by confusion of consciousness. After the abdominal computerized tomography scan revealed the
presence of a renal hematoma, transcatheter arterial embolization was performed on her. Unexpectedly, three days
later, the patient had severe anemia and consciousness disorders again. Highly suspecting renal rebleeding, we
performed a repeated angiography for the patient. After confirming the bleeding, embolization was carried out
again. The renal bleeding stopped, and the patient’s hemoglobin level gradually stabilized. Regrettably, this patient
ultimately died due to multiple systemic infections.
Conclusions WS that occurs in CTDs can evolve into critical and severe conditions. Infection, immune complex
deposition, thrombocytopenia, abnormal coagulation function, complement activation, autoantibodies production,
and glucocorticoid treatment in patients with CTDs are potentially linked to the development of WS. The treatment
strategies for WS should be guided by hemodynamic status.
Keywords Wunderlich syndrome, Spontaneous renal hemorrhage, Connective tissue disease, Systemic lupus
erythematosus, Transcatheter arterial embolization
Creator
Yingzi Zhu1 and Lingli Dong1*
Source
https://doi.org/10.1186/s12245-025-00868-6
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Yingzi Zhu1 and Lingli Dong1*, “Recurrent Wunderlich syndrome in systemic lupus erythematosus: a case report,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12738.