Cases reported "Hematuria"

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1/11. hypercalciuria preceding IgA nephropathy in a child with haematuria.

    We describe a child with isolated haematuria who was diagnosed and successfully treated for idiopathic hypercalciuria for 6 months, after which IgA nephropathy was demonstrated on renal biopsy performed due to the relapse of haematuria in spite of low calciuria levels. To our knowledge, this is the first case evaluated systematically in the literature shown to have IgA nephropathy while being followed up for idiopathic hypercalciuria.
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keywords = hypercalciuria
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2/11. Recurrent abdominal and flank pain in children with idiopathic hypercalciuria.

    OBJECTIVE: To evaluate the role of idiopathic hypercalciuria (IH) as a cause of recurrent abdominal pain (RAP) in children. patients AND methods: We retrospectively reviewed the medical records of 124 children referred for various complaints who had 24-h urine calcium excretion greater than 2 mg/kg/d or random urine calcium-creatinine ratio greater than 0.18 mg/mg. RESULTS: Fifty-two children with various clinical complaints had RAP or flank pain. These comprised of 22 males and 30 females, 9 mo to 15.9 y of age, mean 6.7 /- 3.5 y. A family history of urolithiasis was present in 50% of all the children. Only 6 of the 52 children with abdominal pain had renal stones. In addition to abdominal pain, 27 children had hematuria and 10 had urinary incontinence. Mild metabolic acidosis was present in three children, parathyroid hormone activity elevated in two and serum vitamin d activity was increased in nine. All children were treated with increased fluid intake and a reduction in dietary sodium and oxalate and some required treatment with thiazide and antispasmodics. Forty-five cases responded to treatment, 5 failed to improve from therapy, and 2, which were not followed up as patients, were not available. CONCLUSION: We describe 52 children with RAP or back pain due to IH and recommend that IH be considered in the differential diagnosis of RAP in childhood.
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ranking = 2.5
keywords = hypercalciuria
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3/11. Idiopathic hypercalciuria preceding IgA nephritis in a child with recurrent hematuria.

    A 5-year-old boy was investigated after an episode of gross hematuria of non-glomerular origin and was found to have idiopathic hypercalciuria. Despite normalization of calciuria he had recurrent attacks of gross hematuria. Since SDS-PAGE analysis of urinary proteins indicated a glomerular origin of hematuria, a renal biopsy was performed and revealed IgA nephropathy. We believe that association of hypercalciuria and IgA nephropathy is by chance, since both are frequently found in children with hematuria. Also, we recommend all children with well-controlled hypercalciuria who experience further attacks of gross hematuria be evaluated for glomerular disease.
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ranking = 3.5
keywords = hypercalciuria
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4/11. Acquired hyperoxaluria and haematuria in children.

    Two children with extensive ileal resection are reported. They developed gross haematuria of "non-glomerular origin", without stones or nephrocalcinosis. Previous reports indicate that acquired hyperoxaluria is common in children with a variety of intestinal disorders. Our patients had hyperoxaluria. We think that hyperoxaluria may be the cause of haematuria through a pathogenetic mechanism similar to the one ascribed to haematuria secondary to hypercalciuria and hyperuricosuria.
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keywords = hypercalciuria
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5/11. hypercalciuria as a cause of genital bleeding in a 6-year-old girl.

    STUDY OBJECTIVE: To document an unusual cause of genital bleeding in a 6-year-old girl. DESIGN: Case report. SETTING: Outpatient pediatric gynecology clinic in a tertiary care hospital. RESULTS: Clinical presentation of a case of genital bleeding secondary to hypercalciuria in a 6-year-old female. Gynecologic investigations were negative. There were hematuria on urinalysis and an elevated calcium-to-creatinine ratio on initial presentation; however, no evidence of urolithiasis was found on ultrasound. In the context of negative investigations and persistent episodes of bleeding, the hypercalciuria was treated with hydrochlorothiazide. Normalization of calciuria was associated with the end of genital bleeding episodes. CONCLUSION: hypercalciuria with microcrystals and urethral irritation should be considered as part of the differential diagnosis for genital bleeding in girls.
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keywords = hypercalciuria
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6/11. Atypical idiopathic hypercalciuria in an adolescent.

    Idiopathic hypercalciuria (IH) in adults is recognized as a cause of urolithiasis. If IH is symptomatic, the symptoms are hematuria, renal colic, or obstructive uropathy with or without infection. In children, IH has been linked to the spectrum of urinary symptoms including hematuria, pyuria, dysuria, recurrent urinary infections, abdominal or suprapubic pain, proteinuria, and the frequency-urgency syndrome. hematuria may appear prior to the appearance of stones, and thiazide therapy appears to prevent stone formation by decreasing urinary calcium excretion. This report describes an older adolescent with hematuria and flank pain. His urinary chemistry values were not consistently typical of IH, but a thiazide trial with withdrawal challenge was diagnostic. His case is remarkable because, though essentially an adult, his disease was typical of prepubertal disease. Adolescents with unexplained urinary symptoms should be evaluated for IH. The urinary calcium-creatinine ratio may not be elevated, and timed urinary calcium may be equivocal. In some cases a thiazide trial may be valuable and cost effective.
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ranking = 2.5
keywords = hypercalciuria
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7/11. hypercalciuria in children with juvenile rheumatoid arthritis: association with hematuria.

    After discovering juvenile rheumatoid arthritis (JRA), hematuria, and urolithiasis associated with hypercalciuria in two children, urinary calcium excretion was examined in 38 patients with JRA. fasting urine calcium/creatinine (mg/mg) (UCa/UCr) ratios were increased (greater than 0.21) in 12 patients, who had a mean UCa/UCr ratio of 0.34 /- 0.14, compared with 0.09 /- 0.06 in 26 normocalciuric patients with JRA. Increased UCa/UCr ratios were found more frequently in patients with systemic JRA (P less than 0.05); however, no relationship between UCa/UCr ratios and either functional classification or drug therapy was observed. Four children with increased urine calcium to creatinine ratios were examined more extensively. Twenty-four-hour urine calcium excretion ranged from 4.0 to 7.2 mg/kg/24 hours. An orally administered calcium loading test demonstrated fasting hypercalciuria after dietary calcium restriction in these four patients. serum calcium, bicarbonate, phosphorus, and parathyroid hormone values were normal. hematuria was found in six of 12 hypercalciuric patients with JRA but in only three of 26 normocalciuric patients (P less than 0.016). We conclude that urinary calcium excretion is frequently increased in patients with JRA and that hypercalciuria may be related to the pathogenesis of hematuria in some of them.
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ranking = 1.5
keywords = hypercalciuria
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8/11. hematuria preceding renal calculus formation in children with hypercalciuria.

    Five children were evaluated for painless hematuria; currently recommended diagnostic studies were unsuccessful in determining a diagnosis. A renal calculus subsequently was passed or detected radiographically in each child from 14 to 20 months after the initial evaluation. hypercalciuria was then demonstrated by quantitation of 24-hour urinary calcium excretion or by measurement of urinary calcium/creatinine ratio. calculi and hematuria have not recurred following thiazide therapy. We infer that idiopathic hypercalciuria was a probable cause of the unexplained painless hematuria.
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ranking = 2.5
keywords = hypercalciuria
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9/11. The association of idiopathic hypercalciuria and asymptomatic gross hematuria in children.

    Seven children with asymptomatic gross hematuria are described. Six had recurrent hematuria; one had a single episode. Occasional global glomerulosclerosis and/or mesangial electron dense deposits were present in the three patients in whom renal biopsy was performed; the changes were felt to be insufficient to account for the hematuria. None of the patients had urolithiasis or any significant urinary tract abnormality. One was an adopted child; a family history of urolithiasis was obtained in the other six. Idiopathic hypercalciuria was documented in six patients; the seventh subsequently passed a calcium oxalate calculus. One patient is 10 weeks of age at the time of this submission. Of the remainder, three patients received no specific therapy; renal calculi developed six months, six years, and eight years later. Three patients were treated with a thiazide diuretic soon after onset of hematuria and confirmation of idiopathic hypercalciuria; there was complete cessation of hematuria within five days with no recurrence as long as therapy was continued. We suggested that measurement of urinary calcium excretion as part of the initial evaluation of a child with gross hematuria may, in some cases, obviate invasive investigations and allow for effective therapy.
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ranking = 3
keywords = hypercalciuria
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10/11. Macroscopic hematuria secondary to hypercalciuria and hyperuricosuria.

    An adult presenting with asymptomatic gross hematuria attributable to hypercalciuria and hyperuricosuria is described. Extensive evaluations for other causes of hematuria were negative, and the gross hematuria resolved with treatment of the hypercalciuria and hyperuricosuria. hematuria commonly attributable to these metabolic causes in children may also occur in adults. A 24-hour urine collection for the measurement of calcium and uric acid excretion in adults without nephrolithiasis may play an important role in the evaluation of hematuria.
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ranking = 3
keywords = hypercalciuria
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