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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2014  |  Volume : 25  |  Issue : 1  |  Page : 117-120
Recurrent epistaxis revealing a non-catheter-related superior vena cava syndrome in a hemodialysis patient: Unmasking undifferentiated connective tissue disease

1 Department of Nephrology and Dialysis, Louis Jaillon General Hospital, Saint Claude, France
2 Department of Secondary Care, Louis Jaillon General Hospital, Saint Claude, France
3 Department of Radiology, Louis Jaillon General Hospital, Saint Claude, France
4 Department of Emergency and Trauma, Louis Jaillon General Hospital, Saint Claude, France
5 Department of Internal Medicine, Louis Jaillon General Hospital, Saint Claude, France

Correspondence Address:
O Dahmani
Department of Nephrology, Louis Jaillon General Hospital, Saint Claude
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DOI: 10.4103/1319-2442.124522

PMID: 24434394

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We report a case of an 80-year-old Caucasian woman on maintenance hemodialysis for almost three years through a right-tunneled jugular catheter. She presented with recurrent epistaxis for which she was periodically blood transfused despite erythropoietin therapy. She continued manifesting epistaxis, which was progressively emerging as a sign related to superior vena cava syndrome due to mediastinal mass. Laboratory investigations revealed active immunological abnormalities thereafter. Malignant superior vena syndrome remains an uncommon com­plication in this population related to a history of or ongoing central vein catheterization. Pro­longed oozing from the vascular site was the first alerting sign of the existence of this syndrome. We conclude that sometimes the transformation of undifferentiated connective tissue disease in the presence of epidermoid carcinoma of the superior mediastinum may be revealed during the use of catheters in dialysis.

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