Cause Of Hematuria In Children Research Articles

Investigating hematuria among young Indian adults using MDCT urography.

Hematuria may suggest bladder cancer, renal cell carcinoma, UUT-UCC, or urinary tract stones. Therefore, it is of interest to use Multi-Detector Computed Tomography (MDCT) to determine the cause of hematuria in children and connect MDCT results with cystoscopic and histological findings. The study included 110 young people under 40 with microscopic or macroscopic hematuria. A clinical exam and complete history were recorded. MDCT data from non-contrast and contrast-enhanced scans were properly documented. Histopathological and cystoscopic findings were noted alongside MDCT data when appropriate. The study's typical patient was 26 years old, 66% male. Eighty of the cases had hematuria as the cause. In 66 of 80 individuals, renal or ureteric calculi were the most common clinically relevant outcomes. There were four renal and four UB masses. Two cases of renal papillary necrosis and four of pyelonephritis/renal abscess were identified. MDCT diagnosed renal and vesical masses 100% accurately. MDCT can diagnose and treat hematuria, especially in young men, according to one study. The findings emphasize clinical awareness and targeted diagnosis. Further research is needed to determine hematuria causes and prevention across demographics.

Renal arteriovenous malformation in a 14-year old girl with gross hematuria

Renal arteriovenous malformation (AVM) is a rare cause of gross hematuria in children and adolescents that may present so acute and severe hematuria, leading to significant anemia in patients. We present a 14-year old girl with acute massive gross hematuria with no history of trauma or coagulation defect. Although AVM not common, it should be included in the differential diagnosis of gross hematuria in children and adolescents.

A case report of a young girl with recurrent hematuria: a missed diagnosis - renal nutcracker syndrome

BackgroundNutcracker syndrome is an easily missed cause of hematuria in children. It is characterized by left renal vein entrapment between the abdominal aorta and the superior mesenteric artery causing renal venous hypertension. Intermittent hematuria and orthostatic proteinuria with or without abdominal or flank pain are the common clinical manifestations. Presence of variable non-specific symptoms and non-significant physical findings results in a delayed diagnosis.Case presentationWe present a ten -year -old girl with four episodes of painless gross hematuria and recurrent microscopic hematuria since the age of two years. Doppler ultrasound showed left renal vein compression while 3 D computerized tomography angiography confirmed the diagnosis of an anterior nutcracker. The patient was conservatively treated with nutritional support (pediasure complete formula and high calorie food), iron supplements and followed up, monitored for anemia, hypertension and renal insufficiency.ConclusionNutcracker syndrome is a rare cause of recurrent gross hematuria in children. A high index of suspicion and proper imaging is needed to reach a proper diagnosis and avoid the psychological and financial stress on the family.

A Case Report and Review of Transitional Cell Carcinoma in Children

Transitional cell carcinoma (TCC) is a rare cause of hematuria in children. This type of urothelial bladder tumor is typically low grade and carries a good prognosis. In this article, a case report is presented along with a review of the literature on TCC in children.

Reply to the correspondence letter by Park et al. “Renal Doppler ultrasonography in the diagnosis of nutcracker syndrome”

We appreciate the interest of and comments by Park et al. Nutcracker syndrome is certainly an under-recognized cause of hematuria in children. It was noted that left renal venography is the most accurate modality to identify nutcracker syndrome, and it was concluded that renal Doppler ultrasonography should be considered as an initial screening tool in children with hematuria. We agree with this opinion; however, we would like to make additional comments. We described nutcracker syndrome as an uncommon but under-recognized cause of hematuria in children. Yang et al. also consider nutcracker syndrome as a rare clinical condition [3]. Our case report is an attempt for physicians to consider this diagnosis, especially in the emergency department, when evaluating children with hematuria, especially hematuria associated with abdominal pain. We agree with the opinion of ultrasonography being the initial investigation in children with isolated hematuria. However, in the emergency department when patients present with undifferentiated abdominal pain, other alternative diagnoses should be considered. Computed tomography (CT) scans are helpful in identifying and excluding other causes of acute abdominal pain. Reports from emergency departments indicate the use of CT scan for the diagnosis of nutcracker syndrome [2]. The diagnostic value of CT scan is well established in the evaluation of nutcracker syndrome and is well correlated with renal venography and renocaval pressure gradient [1]. An important limitation of the use of ultrasound is that it is operator-dependent and may not be feasible in the emergency departments at all times.

Le syndrome casse-noisette ( Nutcracker) : une cause rare d’hématurie

Nutcracker syndrome is a rare cause of hematuria in children. Clinical signs relate to compression of the left renal vein between the aorta and the superior mesenteric artery. The diagnosis is suggested on cystoscopy, which reveals unilateral hematuria, and confirmed by imaging. We report the case of a 4-year-old child who presented nutcracker syndrome confirmed by CT angiography of the abdomen after excluding the other causes of hematuria. Through this observation, we emphasize the reality of this syndrome in children and the value of imaging in the evaluation of this rare affection.

PRIMARY EWING'S SARCOMA OF THE BLADDER ASSOCIATED WITH AN ELEVATED ANTINUCLEAR ANTIBODY TITER

Lower urinary tract malignancy is an uncommon cause of hematuria in children. The most common pediatric bladder malignancies are rhabdomyosarcoma, leiomyosarcoma and transitional cell carcinoma. To our knowledge primary Ewing's sarcoma of the bladder has not been previously reported in any age group. We report a case of primary Ewing's sarcoma of the bladder associated with elevated antinuclear antibody titer. CASE REPORT A previously healthy 15-year-old white girl presented for evaluation of painless gross hematuria and clot urinary retention. Physical examination was normal and medical history was unremarkable. Urinalysis revealed numerous isomorphic erythrocytes but no pyuria or bacteriuria. Creatinine, serum electrolytes, liver function tests, alkaline phosphatase, lactate dehydrogenase, hematocrit and coagulation studies were normal. An antinuclear antibody titer that was obtained to rule out nephrological hematuria was elevated at 1:10,240 (normal up to 1:15). Excretory urogram showed normal kidneys and an unremarkable upper urinary tract. However, a filling defect was noted in the bladder. Cystoscopic examination revealed a 2 x 2 cm. bleeding, sessile globular tumor with focal areas of necrosis and no papillary features. The lesion was at the right anterolateral bladder wall. Transurethral resection was incomplete and biopsy specimens were not consistent with transitional cell carcinoma. Immunohistochemical and electron microscopy studies revealed small round blue malignant cells (fig. 1). Staging chest, abdomen and pelvis computerized tomography (CT) failed to reveal intra-abdominal or retroperitoneal pathology.

Metabolic disturbance as a cause of recurrent hematuria in children

Metabolic disturbance as a cause of recurrent hematuria in children. To evaluate metabolic disturbance as a cause of hematuria, 250 children, aged eight months to fourteen years, with recurrent hematuria were studied. In the present series, metabolic disturbance was mainly due to idiopathic hypercalciuria (IH), the most common etiology of hematuria without proteinuria in childhood Sixty-seven (27%) of the children had IH, ten children (4%) had hyperuricosuria, and 27 (11%) had nephrolithiasis. To better characterize the IH into renal (RH) or absorptive hypercalciuria (AH) subtypes, 45 of the 67 children (ranging age from six to twelve years) were further submitted to an oral calcium load test. Eighteen patients (40%) had AH, 7 (15.5%) RH and 20 (44.4%) could not be classified as having AH or RH [indeterminant (ID) idiopathic hypercalciuria group]. Intravenous pyelography or ultrasound were normal in all children. The oral calcium load test may be useful in characterizing the subtype of IH in some children; however, a great number of the IH children were characterized as indeterminant. Also hyperuricosuria, recently described as another metabolic disturbance associated with hematuria, may be an important cause of recurrent hematuria in children.