Microscopic Hematuria

Definition: Presence of red blood cells in urine

Possible causes of Hematuria:

• Pre-Renal
  • Coagulopathies - TTP, Hemophilia
  • Wilm's Tumor
  • Sickle Cell Disease
  • Collagen Vascular Disease and Vasculitis
• Renal
  • Nonglomerular
    • Pyelonephritis
    • AVMs
    • Neoplasms
    • Tuberculosis
    • Polycystic Kidney
  • Glomerular
    • Alport's Syndrome
    • Berger's Disease
    • Lupus Nephritis
    • Benign familial hematuria
    • AVMs
    • Vasculitits
    • Glomerulonephritis
• Post Renal
  • Renal Stones
  • Neoplasms
  • Uretrhritis
  • Cystitis
  • BPH/prostatitis
  • Eididymititis
• False Positives
  • Vaginal bleeding
  • Hemoglobinuria
  • Foods - beets, black berries, fava beens, rhubarb
  • Medications - quinidine, dilantin, rifamipin, sulfasalazine, phenanzopyridine, phenothiazine
  • Porphyrins
• Physiologic Causes - Exercise, fever, trauma

Possible work up modalities:

• IVP
• Renal Ultrasound
• Cystoscopy
• Sickle Cell testing - including r/o sickle cell trait
• 24hour urine for uric acid and calcium
• CBC
• Urine cytology - to evaluate for transitional cell CA
• Sedimentation Rate
• PPD
• Coagulation testing
• BMP