Retroperitoneal haemorrhage with abscess formation complicating Waldenström's macroglobulinaemia

The complications of bleeding in patients with Waldenström's macroglobulinaemia (WM) are relatively well described. The pathophysiology of such a haemorrhagic diathesis is complex and involves the inhibition and depression of coagulation factors as well as qualitative and quantitative platelet abnormalities. Treatment of WM must be targeted at the underlying lymphocellular malignancy, but amelioration of the hyperviscous state and component transfusion(s) to correct abnormal coagulation parameters will decrease the incidence of bleeding. A case of WM with E. coli urinary tract infection and subsequent retroperitoneal haemorrhage with abscess formation and sepsis is presented. The pathophysiology and management of such patients is described.