Forty-four episodes of sicklemic hematuria occurring in 40 patients during a 12-year period were reviewed. Seven of seven patients had evidence of a hyperactive fibrinolytic system. Fifteen of 38 pyelograms demonstrated obstruction of some portion of the collecting system by blood clots that cleared on follow-up studies (nine patients) in 2 to 37 days. Hematuria subsided spontaneously in 20 episodes. Aminocaproic acid was used in 22 patients whose hematuria prior to aminocaproic acid administration averaged twice as long as the total duration in patients undergoing spontaneous remission. Hematuria subsided in 2.2 ± 0.3 days in the group treated with aminocaproic acid. Therapy with aminocaproic acid in this study was not associated with an increased incidence of thrombosis. Because of its potential untoward effects, however, EACA therapy in this disorder should be limited to patients with severe or prolonged hematuria.
(Arch Intern Med 136:678-680, 1976)