hematuria in children
Introduction
Introduction Pediatric hematuria is one of the common symptoms in pediatrics. It can coexist with other symptoms of the urinary system or it can exist alone. In addition to hematuria in the presence of kidney damage, hematuria may also occur in the urinary system and systemic diseases below the kidney.
Cause
Cause
Causes of hematuria Many hemoglobins can be excreted with urine, and urine hemoglobin qualitative test is positive, called hemoglobinuria. Hemoglobinuria is characterized by a strong brown or transparent soy sauce color. There is no red blood cells at the time of microscopic examination, but the occult blood test is positive, caused by systemic diseases, and also caused by diseases of the urinary system itself. Common causes are nephritis and urinary tract. Infection, urinary calculi and structural abnormalities of the urinary system.
Examine
an examination
Related inspection
Water vasopressin test urine routine
Most cases of hematuria in children can be diagnosed by symptoms, signs and laboratory tests. Some children can be diagnosed by imaging, endoscopy and renal biopsy.
(1) Take 2ml of fresh urine in a test tube and boil it to destroy other peroxidases that can cause false positives. After cooling, add 1-2 drops of glacial acetic acid and mix.
(2) Slowly add the mixed reagent (mix 50g/L aminopyrine ethanol solution and 3% hydrogen peroxide in the same amount) to the test tube along the tube wall to form a contact surface with urine. Immediately observe the color of the two liquid interface. If the lavender to purple blue ring is formed, it is positive for occult blood test; if it does not develop color after 3 minutes, it is negative for occult blood test.
Diagnosis
Differential diagnosis
Differential diagnosis of urinary blood in children:
1. Infants and children with hematuria accompanied by deformities of deafness, eye disease or other parts, it is necessary to consider whether the kidney is also deformed.
2. Children with hematuria accompanied by decreased urine output, facial edema, high blood pressure and low back pain may be acute or chronic glomerulonephritis.
3. The number of hematuria with urinary tract increases in children, and there is always a feeling of bulging in the lower abdomen, or urinary tract pain when urinating, indicating inflammation of the urethra or bladder.
4. If the child has hematuria and has difficulty in urinating and unbearable pain, he may have urinary calculi.
5. If the child is accompanied by hemorrhage, skin bleeding, nasal bleeding, gums and other parts of the bleeding, be alert to bleeding disorders such as thrombocytopenic purpura, aplastic anemia, acute leukemia, hemophilia.
6. Children with hematuria accompanied by fever, general malaise, and apathetic, think of the possibility of systemic infectious diseases.
7. If the child's parents and relatives have kidney disease, the child's hematuria should be alert to the possibility of hereditary nephritis.
8. There are also some reasons for temporary hematuria. For example, after exercise, hematuria, some children found hematuria after strenuous activities such as running or playing, but the body has no obvious discomfort, and there is no other combined symptoms. This is hematuria after exercise, which is caused by kidney damage after strenuous exercise. There is no special treatment for exercise hematuria. You can take some hemostatic drugs and let the child rest until the hematuria disappears. In the future, you should gradually increase from a small amount of exercise to improve your child's body and kidney resistance to exercise.
9. Certain drugs can cause damage to the kidneys and cause hematuria, such as sulfa drugs, gentamicin, kanamycin, angtong, and cold. Therefore, when children need to use these drugs due to illness, they should be used under the guidance of a doctor to ensure safety without side effects.
Most cases of hematuria in children can be diagnosed by symptoms, signs and laboratory tests. Some children can be diagnosed by imaging, endoscopy and renal biopsy.
