HC is a common complication following HSCT. Risk factors include viral infections, cyclophosphamide and busulfan usage, pelvic irradiation, older age at transplantation, allogeneic HSCT and GvHD. The severity of HC ranges from mild hematuria to life-threatening bleeding. Here, we present a seven-and-a-half-yr-old boy with Wiskott-Aldrich syndrome who experienced a late onset Grade III hemorrhagic cystitis following HSCT from his fully matched sibling. A Grade I GvHD localized to skin developed on day +11 and prednisolone therapy was given between the 11th and 22nd d. Myeloid and platelet engraftments were achieved +13 and +16 d, respectively. A gross hematuria began on the 21st post-transplant day. The urine cultures for bacterial or fungal organisms were negative. Urine analysis by PCR revealed a CMV viruria. Following systemic ganciclovir treatment, urinary CMV became negative but hemorrhagic cystitis did not improve. Due to the probability of existing BK virus or adenovirus, two doses of cidofovir were administered intravesically. As he continued to have painful hematuria with large clot formations, two doses of intravesical hyaluronic acid were applied. Macroscopic hematuria resolved within four d after the second dose. Complete remission was achieved on day +77. Finally, intravesical administration of hyaluronic acid seems to be effective and safe and can be a promising treatment in patients suffering from severe and late onset HC.

Introduction and Aims: Synthetic cannabinoid (SCs) use has been increasing in Turkey parallel to the rest of the world. It is more commonly named as bonzai, jamaica, k2 or spice and is used illegally for pleasure and hallucinogenic effects. Here we presented six patients who were followed up in Nephrology clinic with acute kidney injury (AKI) due to synthetic cannabinoid usage in last six months . Methods: Single centre experience; Here we presented six patients who were followed up in Nephrology clinic with acute kidney injury (AKI) due to synthetic cannabinoid usage in last six months . Results: Six male patients aged between 28-42 years were admitted to the nephrology clinic, after presenting to the ER with nausea, vomiting and abdominal pain and whose laboratory results showed high levels of urea and creatinine. Clinical and laboratory findings in all six patients are summarized in Table 1. The most evident complaints of patients were nausea and vomiting. The patients declared that nausea-vomiting started approximately 10-16 hours before coming to the ER and approximately 2-4 hours after inhalation. All 6 cases have abdominal pain starting from the epigastric region and felt more severely in both lumbar regions. Metabolic alkalosis was observed in 4, normoacidemia in 2 patients. Kidney biopsies were performed in 2 of the cases (Case 3 and 5) revealed evidence of acute tubular necrosis, focal tubular atrophy, flattened and granulated epithelium and interstitial fibrosis. On the other hand; hypertrophic and global sclerotic glomerulies were observed. Vessels were unremarkable, with no significant staining on the immunofluorescence. Conclusions: SCs using is growing up daily, particularly in young generation and becoming a serious public health threat. In less than 6 months, a total of 6 cases were hospitalised in our clinic and unfortunately 4 of them (%66) became dependent on

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