HEMATURIA BASIC COURSE OF DIAGNOSIS Xiaoqi Xu Renji hospital Shanghai second medical University
HEMATURIA BASIC COURSE OF DIAGNOSIS Xiaoqi Xu Renji Hospital Shanghai Second Medical University
CONTENT Definition of hematuria 雷 Etiology Clinical feature E Differential diagnosis 雪 Laboratory tests T Accompanied symptoms
CONTENT Definition of hematuria Etiology Clinical feature Differential diagnosis Laboratory tests Accompanied symptoms
DEFINITION More than three red blood cells are found in centrifuged urine per high-power field microscopy (>3 RBC/HP) Normal urine. no red blood cell or less than three red blood celll
DEFINITION More than three red blood cells are found in centrifuged urine per high-power field microscopy ( > 3 RBC/HP). Normal urine: no red blood cell or less than three red blood cell
According to the amount of rBc in the urine, hematuria can be classified as o microscopic hematuria normal colour with eyes gross hematuria tea-colored, cola-colored, pink or even red
According to the amount of RBC in the urine, hematuria can be classified as: ⚫ microscopic hematuria: normal colour with eyes ⚫ gross hematuria: tea-colored, cola-colored, pink or even red
ETIOLOGY Y Diseases of the urinary system-the most common cause Vascular arteriovenous malformation arterial emboli or thrombosis arteriovenous fistular nutcracker syndrome renal vein thrombosis loin-pain hematuria syndrom cogulation abnormality excessive anticogulation
ETIOLOGY ✓ Diseases of the urinary system—the most common cause Vascular arteriovenous malformation arterial emboli or thrombosis arteriovenous fistular nutcracker syndrome renal vein thrombosis loin-pain hematuria syndrom cogulation abnormality excessive anticogulation
Glomerular IgA nehropathy thin basement membrane disease(incl Alport syndrome) other causes of primary and secondary glomerulonephritis Interstitial allergic interstitial nephritis analgesic nephropathy renal cystic diseases acute pyelonephritis tuberculosis renal allograft rejection
Glomerular IgA nehropathy thin basement membrane disease (incl.Alport syndrome) other causes of primary and secondary glomerulonephritis Interstitial allergic interstitial nephritis analgesic nephropathy renal cystic diseases acute pyelonephritis tuberculosis renal allograft rejection
Uroepithelium malignancy vigorous excise trauma papillary necrosis cystitis/urethritis/prostatitis(usually caused by infection) parasitic diseases(e.g. schistosomiasis) nephrolithiasis or bladder calculi Multiple sites or source unknown hypercalciuria hyperuricosuria
Uroepithelium malignancy vigorous excise trauma papillary necrosis cystitis/urethritis/prostatitis(usually caused by infection) parasitic diseases (e.g. schistosomiasis) nephrolithiasis or bladder calculi Multiple sites or source unknown hypercalciuria hyperuricosuria
System disorders a. Hematological disorders aplastic anemia leukemia allergic purpura hemophilia TP(idiopathy thrombocytopenic purpura b Infection infective endocarditis septicemia epidemic hemorrhagic fever(hantaan virus) scarlet fever(B-hemolytic streptococcus) leptospirosis (leptospire) filariasis (Wuchereria bancrofti, Brugia malayi
✓ System disorders a. Hematological disorders aplastic anemia leukemia allergic purpura hemophilia ITP (idiopathy thrombocytopenic purpura) b. Infection infective endocarditis septicemia epidemic hemorrhagic fever (Hantaan virus) scarlet fever (-hemolytic streptococcus) leptospirosis (leptospire) filariasis (Wuchereria bancrofti, Brugia malayi)
Connective tissue diseases systemic lupus erythematosus (Sle) polyarteritis nodosa d. Cardiovascular diseases hypertensive nephropathy chronic heart failure renal artery sclerosis e. Endocrine and metabolism diseases gout diabetes mellitus
c. Connective tissue diseases systemic lupus erythematosus (SLE) polyarteritis nodosa d. Cariovascular diseases hypertensive nephropathy chronic heart failure renal artery sclerosis e. Endocrine and metabolism diseases gout diabetes mellitus
Y Diseases of adjacent organs to urinary tract appendicitis salpingitis carcinoma of the rectum carcinoma of the colon uterocervical cancer Y Drug and chemical agents sulfanilamides anticogulation cyclophosphamide mannitol √ miscellaneous exercise“ idopathic” hematuria
✓ Diseases of adjacent organs to urinary tract appendicitis salpingitis carcinoma of the rectum carcinoma of the colon uterocervical cancer ✓ Drug and chemical agents sulfanilamides anticogulation cyclophosphamide mannitol ✓ miscellaneous exercise “idopathic” hematuria