Vasculitis-related Wunderlich's syndrome treated without surgical intervention.

Spontaneous renal or peri-renal bleeding or so-called Wunderlich's syndrome is a rare but potentially life-threatening condition. Most reported cases are Caucasian and caused by ruptured renal tumors, either benign or malignant. The syndrome has never been documented in Orientals with underlying autoimmune diseases. We report 3 cases of spontaneous renal bleeding with concurrent systemic lupus erythematosus and vasculitis presenting with flank or abdominal pain, anemia, leukocytosis, and a high C-reactive protein. All were diagnosed by computerized tomography, magnetic resonance imaging or angiography, and treated successfully with glucocorticoids and cytotoxic agents without surgical intervention.