Microscopic hematuria in children

Abstract

Keywords: children hypertension mass screening microscopic hematuria proteinuria a b s t r a c tThe occurrence of microscopic hematuria (microhematuria) in children often causes concern for parents, patients, and physicians. The condition is usually benign in nature, so unnecessary laboratory tests should be avoided. A detailed history and physical examination must be undertaken, but a complete urinalysis with a microscopic examination is usually the only laboratory test required. The differential diagnosis of microhematuria is extensive, but the most important differentiating feature is the presence or absence of proteinuria. Urologists should ensure that serious conditions are not overlooked, unnecessary tests are not performed, and parents are properly reassured. However, there is still no consensus on the standard evaluation that should be used to determine microhematuria in children. The aim of this article is to provide a brief review of microhematuria in children and suggest a stepwise approach that can be used to detect major and/or treatable problems while avoiding unnecessary tests.

Risk Factors for Urinary Tract Infections in Children with Hematuria in the Emergency Department

“…An acute bacterial urinary tract infection is the most common cause of gross hematuria in children [27]. Meanwhile, the most common causes of microscopic hematuria include benign familial hematuria, hypercalciuria, and immunoglobulin A (IgA) nephropathy [28]. In cases of recurrent gross hematuria in children, consideration should be given to IgA nephropathy, Alport syndrome, or thin glomerular basement membrane disease [29].…”

Haematuria in children

“…Although haematuria can be a very important sign of renal or urinary tract disease, the concurrent finding of proteinuria is a more important diagnostic and prognostic factor, as it can indicate the presence of glomerular disease (Chung et al, 2011;Meyers, 2004;Patel and Biggler, 2001).…”

“…The most common causes of persistent microscopic haematuria include Ig-A nephropathy, Alport syndrome, hypercalciuria, thin basement membrane disease or post-streptococcal GN. Isolated microscopic haematuria is frequently observed in febrile illnesses and resolves spontaneously (Chung et al, 2011;Lunn and Forbes, 2012).…”

“…Causes of this constellation of symptoms and signs include post-infectious GN (PIGN), HSP, haemolytic-uraemic syndrome, membrano-proliferative GN or Ig-A nephropathy. Further indications for specialist referral include the presence of systemic disease and a strong family history of renal disease (Chung et al, 2011;Lunn et al, 2012;Meyers, 2004).…”

Hematuria en la niñez: revisión sistemática cualitativa

“…L a presencia de sangre en la orina de un niño, sea macro o microscópica, es un motivo de consulta frecuente que ocasiona gran ansiedad en el niño y en la familia por la percepción de ser una enfermedad grave [1]. La hematuria es la alteración urinaria más común en la infancia, con una prevalencia aproximada en niños y niñas de diferentes países entre los seis y 15 años, del 1% al 2% [2,3]. En niños la hematuria más frecuente es la microscópica con un 60% al 70% de los casos, mientras que la macroscópica tiene una prevalencia de al menos 1,3 casos por cada 1.000 niños, donde las etiologías no traumáticas más frecuentes son la nefropatía por inmunoglobulina A (IgA) y la glomerulonefritis posestreptocócica [4].…”