Hematuria differential diagnosis: Difference between revisions

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|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! colspan="3" rowspan="5" |Diseases
! colspan="3" rowspan="5" |Diseases
| rowspan="5" |Type of hematuria
| colspan="9" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
| colspan="9" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
! colspan="8" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
! colspan="8" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
Line 47: Line 46:
| rowspan="9" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Glomerular disease|Glomerular diseases]]
| rowspan="9" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Glomerular disease|Glomerular diseases]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[IgA nephropathy|IgA nephropathy (Berger nephropathy)]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[IgA nephropathy|IgA nephropathy (Berger nephropathy)]]
|Microscopic
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
Line 67: Line 65:
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Alport syndrome|Hereditary nephritis (Alport syndrome)]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Alport syndrome|Hereditary nephritis (Alport syndrome)]]
|Microscopic
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
Line 96: Line 93:
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Poststreptococcal glomerulonephritis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Poststreptococcal glomerulonephritis]]
|Microscopic
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[MPGN|Mesangioproliferative glomerulonephritis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[MPGN|Mesangioproliferative glomerulonephritis]]
|Microscopic
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
Line 140: Line 135:
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Focal segmental glomerulosclerosis|Focal segmental glomerular sclerosis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Focal segmental glomerulosclerosis|Focal segmental glomerular sclerosis]]
|Microscopic
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
Line 162: Line 156:
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Rapidly progressive glomerulonephritis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Rapidly progressive glomerulonephritis]]
|Microscopic
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lupus nephritis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lupus nephritis]]
|Microscopic
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Thin basement membrane disease]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Thin basement membrane disease]]
|Microscopic
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fabry's disease|Fabry disease]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fabry's disease|Fabry disease]]
|Microscopic
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| rowspan="5" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tubulointerstitial diseases of the kidney|Tubulointerstitial diseases]]
| rowspan="5" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tubulointerstitial diseases of the kidney|Tubulointerstitial diseases]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Renal papillary necrosis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Renal papillary necrosis]]
|Gross
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Interstitial nephritis|Acute interstitial nephritis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Interstitial nephritis|Acute interstitial nephritis]]
|
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Analgesic]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Analgesic]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Nephrolithiasis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Nephrolithiasis]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
Line 339: Line 325:
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Reflux nephropathy|Reflux nephropathy (hydronephrosis)]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Reflux nephropathy|Reflux nephropathy (hydronephrosis)]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Malignancy]]
| rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Malignancy]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Renal cell carcinoma|Renal cell carcinoma (RCC)]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Renal cell carcinoma|Renal cell carcinoma (RCC)]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Nephroblastoma]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Nephroblastoma]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Transitional cell carcinoma|Transitional cell carcinoma (TCC)]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Transitional cell carcinoma|Transitional cell carcinoma (TCC)]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prostate cancer]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prostate cancer]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Familial|Familial diseases]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Familial|Familial diseases]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Polycystic kidney disease]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Polycystic kidney disease]]
|Micro/Gross
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
Line 494: Line 474:
| rowspan="6" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vascular anomaly|Vascular diseases]]
| rowspan="6" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vascular anomaly|Vascular diseases]]
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Renal vein thrombosis]]
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Renal vein thrombosis]]
| rowspan="2" |Micro/Gross
| rowspan="2" style="background: #F5F5F5; padding: 5px;" | +
| rowspan="2" style="background: #F5F5F5; padding: 5px;" | +
| rowspan="2" style="background: #F5F5F5; padding: 5px;" | +
| rowspan="2" style="background: #F5F5F5; padding: 5px;" | +
Line 527: Line 506:
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Malignant hypertension]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Malignant hypertension]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Polyarteritis nodosa]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Polyarteritis nodosa]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Granulomatosis with polyangiitis|Wegner's granulomatosis polyangiitis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Granulomatosis with polyangiitis|Wegner's granulomatosis polyangiitis]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
Line 593: Line 569:
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Henoch-Schönlein purpura]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Henoch-Schönlein purpura]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urinary system|Lower urinary tract diseases]]
| rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urinary system|Lower urinary tract diseases]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Benign prostatic hyperplasia]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Benign prostatic hyperplasia]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urolithiasis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urolithiasis]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Interstitial cystitis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Interstitial cystitis]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Radiogenic|Radiogenic cystitis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Radiogenic|Radiogenic cystitis]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| rowspan="5" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Systemic diseases]]
| rowspan="5" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Systemic diseases]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hemophilia|Coagulopathy (hemophilia)]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hemophilia|Coagulopathy (hemophilia)]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sickle cell anemia]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sickle cell anemia]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Abdominal aortic aneurysm]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Abdominal aortic aneurysm]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
Line 771: Line 739:
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lymphomas]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lymphomas]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Multiple myeloma]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Multiple myeloma]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| rowspan="8" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious disease|Infectious diseases]]
| rowspan="8" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious disease|Infectious diseases]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pyelonephritis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pyelonephritis]]
|Gross
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
Line 849: Line 814:
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cystitis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cystitis]]
|
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Dyspareunia]]
* [[Dyspareunia]]
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prostatitis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prostatitis]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urethritis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urethritis]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
Line 924: Line 886:
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Epididymitis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Epididymitis]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cytomegalovirus]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cytomegalovirus]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
Line 968: Line 928:
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious mononucleosis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious mononucleosis]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
Line 990: Line 949:
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Condylomata acuminata]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Condylomata acuminata]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urogenital|Urogenital trauma]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urogenital|Urogenital trauma]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Inserted [[bladder]] or [[Ureteral disease|ureteral catheters]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Inserted [[bladder]] or [[Ureteral disease|ureteral catheters]]
|
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Drugs]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Drugs]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Anticoagulants]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Anticoagulants]]
|
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| rowspan="18" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Dark urine]]
| rowspan="16" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Dark urine]]
| rowspan="7" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hemoglobinuria]]
| rowspan="7" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hemoglobinuria]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Autoimmune hemolytic anemia]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Autoimmune hemolytic anemia]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Microangiopathic hemolytic anemia]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Microangiopathic hemolytic anemia]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Thrombotic thrombocytopenic purpura]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Thrombotic thrombocytopenic purpura]]
|
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Paroxysmal nocturnal hemoglobinuria]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Paroxysmal nocturnal hemoglobinuria]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Paroxysmal cold hemoglobinuria]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Paroxysmal cold hemoglobinuria]]
|
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Malaria|Falciparum malaria]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Malaria|Falciparum malaria]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prosthetic heart valve]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prosthetic heart valve]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| rowspan="9" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Myoglobinuria]]
| rowspan="9" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Myoglobinuria]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Crush injury]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Crush injury]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Physical exercise|Vigorous muscle exercise]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Physical exercise|Vigorous muscle exercise]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #F5F5F5; padding: 5px;" |
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hyperthermia|Hyperthermia (Heat stroke)]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hyperthermia|Hyperthermia (Heat stroke)]]
|
| style="background: #F5F5F5; padding: 5px;" |
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Electric shock]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Electric shock]]
|
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Prolonged [[seizure]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Prolonged [[seizure]]
|
| style="background: #F5F5F5; padding: 5px;" |
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Polymyositis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Polymyositis]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Trichinosis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Trichinosis]]
|
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Haff disease]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Haff disease]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Bite injury|Animal venom bite]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Bite injury|Animal venom bite]]
|
| style="background: #F5F5F5; padding: 5px;" |
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|-
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Chemicals]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Phenazopyridine]]
|
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Beeturia|Beet (Beeturia)]]
|
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Revision as of 18:23, 20 July 2018

Hematuria Microchapters

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Steven C. Campbell, M.D., Ph.D. Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [1]

Overview

Gross hematuria(GH) must be distinguished from pigmenturia, which may be due to endogenous sources (e.g., bilirubin, myoglobin,and porphyrins), foods ingested (e.g., beets and rhubarb), drugs (e.g., phenazopyridine), and simple dehydration. This distinction can be made easily by urinalysis with microscopy. Notably, myoglobinuria and other factors can cause false-positive chemical tests for hemoglobin, so urine microscopy is required to confirm the diagnosis of hematuria. GH also must be distinguished from vaginal bleeding in women, which usually can be achieved by obtaining a careful menstrual history, collecting the specimen when the patient is not having menstrual or gynecologic bleeding, or, if necessary, obtaining a catheterized specimen. GH may also be detected by the presence of blood spotting on the undergarments of incontinent patients. After ruling out vaginal bleeding and mimics of hematuria, a urologic source must be suspected.

Differential Diagnosis

Hematuria should be differentiated from other disease which mimic hematuria especially hemoglobinuria and myoglobinuria which are dipstick positive but negative for microscopy.

Hematuria differential diagnosis

Differentiating the diseases that can cause hematuria:

Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab Findings Imaging Histopathology
Low back pain Fever Nausea/Vomiting Urinary symptoms Hypertension Pitting edema Other Ultrasonography CT scan Other
Dysuria Frequency Oliguria Light microscopy Immunoflourescence pattern
Hematuria Glomerular diseases IgA nephropathy (Berger nephropathy) + - - - + + + - -
Hereditary nephritis (Alport syndrome) - - - - - - + -
  • Cataract
  • Hearing loss
 - - Renal Biopsy
  • Irregularly thin and attenuated GBM
  • Splitting of GBM
  • Scarring
Poststreptococcal glomerulonephritis
Mesangioproliferative glomerulonephritis
Focal segmental glomerular sclerosis
Rapidly progressive glomerulonephritis
Lupus nephritis
Thin basement membrane disease
Fabry disease
Tubulointerstitial diseases Renal papillary necrosis
Acute interstitial nephritis + + +
Analgesic
Nephrolithiasis
Reflux nephropathy (hydronephrosis)
Malignancy Renal cell carcinoma (RCC)
Nephroblastoma
Transitional cell carcinoma (TCC)
Prostate cancer
Familial diseases Polycystic kidney disease + - - - - - + +
  • Unilateral or bilateral cysts
  • Hyperdense appearance,
  • Septations
  • Calcifications

Genetic testing demonstrates:

  • Frame insertions/deletions
  • Non-canonical splice site alterations
  • Combined missense changes
  • Interstitial fibrosis
  • Tubular atrophy
  • Thickening and lamellation of tubular basement membranes
  • Microcysts
  • Negative immunofluorescence for complement and immunoglobulin
 Ultrasound
Vascular diseases Renal vein thrombosis + + + - - - - -
  • Asymptomatic
  • Abdominal pain
  • Acute in onset
  • Elevation in serum lactate dehydrogenase
  • Cholesterol levels for hypercholesterolemia
  • Albumin levels for hypoalbuminemia
  • Serum complement levels
  • Diagnostic screening
  • Renal venography: Gold standard
Malignant hypertension
Polyarteritis nodosa
Wegner's granulomatosis polyangiitis
Henoch-Schönlein purpura
Lower urinary tract diseases Benign prostatic hyperplasia
Urolithiasis
Interstitial cystitis
Radiogenic cystitis
Systemic diseases Coagulopathy (hemophilia)
Sickle cell anemia
Abdominal aortic aneurysm
Lymphomas
Multiple myeloma
Infectious diseases Pyelonephritis + + + + + + - -
  • Enlarged kidneys

Contrast nephrograms

-
Cystitis - - - + + + - -
  • Presence of a gas in the bladder wall.
  • Also help to detect the presence of a tumor or a stone.
 MRI
Prostatitis
Urethritis
Epididymitis
Cytomegalovirus
Infectious mononucleosis
Condylomata acuminata
Urogenital trauma Inserted bladder or ureteral catheters
Drugs Anticoagulants
Dark urine Hemoglobinuria Autoimmune hemolytic anemia
Microangiopathic hemolytic anemia
Thrombotic thrombocytopenic purpura
Paroxysmal nocturnal hemoglobinuria
Paroxysmal cold hemoglobinuria
Falciparum malaria
Prosthetic heart valve
Myoglobinuria Crush injury
Vigorous muscle exercise
Hyperthermia (Heat stroke)
Electric shock
Prolonged seizure
Polymyositis
Trichinosis
Haff disease
Animal venom bite

References

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