HEMATURIA (BLOOD IN URINE)

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Last Updated : 1/14/2011
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Kumud P Mehta
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Clinical clues from history and physical examination

Dysuria, loin pain, colic
Hypercalcuria, stone
joint pain, skin rash
SLE, HSP
Bleeding tendency
Coagulation disorders, platelet deficiency
Family history of

hematuria


Benign familial,

Alport's syndrome

, stones
Purpura
HSP
Edema, Hypertension
Glomerulonephritis
Anemia, Splenomegaly
Sickle cell disease
Renal angle tenderness
Urinary tract infection
Renal mass
Wilm's tumor, Polycystic kidney disease, hydronephrosis
Deafness
Alport's syndrome
Painful hematuria
Stones, UTI, hypercalciuria


Salient Features of selected

diseases with hematuria

Alport's Syndrome
It is a triad of persistent hematuria, deafness, familial disease along with eye anomalies which progresses to chronic renal failure especially in males. It is inherited as sex linked recessive / autosomal recessive / autosomal dominant condition. No treatment is available except renal transplant when the child to progresses to ESRD.

IgA nephropathy

It is a non-familial disease of unknown etiology. It presents with persistent microscopic and rarely macro hematuria. In majority of cases, it does not progress to ESRD in pediatric age. But 15% cases of IgA nephropathy in adults end in ESRD. Rarely nephrotic syndrome and hypertension is encountered after many years of onset.

Familial benign hematuria

It also presents with persistent microscopic hematuria and needs to be differentiated from Alport's syndrome since the prognosis is good in Familial benign hematuria whilst chronic renal failure occurs in Alport's syndrome. Final diagnosis is based on audiometry and kidney biopsy on EM.



Contributor Information and Disclosures Kumud P Mehta
Consultant Pediatrician & Pediatric Nephrologist, Jaslok Hospital & Research Centre, Bai Jerbai Wadia Hospital for children, Mumbai, India


First Created : 1/3/2001
References
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