Spontaneous hemomediastinum complicating steroid-induced mediastinal lipomatosis

Spontaneous hemomediastimun is a rare event, occurring in association with bleeding disorders, intratumoral bleeding, or following an abrupt increase in intrathoracic pressure. We report the case of a patient with systemic lu pus erythematosus, nephrotic syndrome, and renal failure, in whom mediastin al lipomatosis (ML) developed following increased corticosteroid therapy, A nticoagulant therapy likely precipitated a massive spontaneous hemomediasti num secondary to diffuse hemorrhage of mediastinal fat, which required emer gency decompressive surgery, Steroid-induced Mi, is common and usually well tolerated, but clinicians should be aware of its potential risk of bleedin g when associated with anticoagulant therapy. This case further emphasizes the bleeding complications of treatment with low-molecular-weight heparin i n patients with renal failure.