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asymptomatic microscopic hematuria

Matthew Truong, Wenqing Cao, Erdal Erturk
A 69 year-old male with a past medical history of hypertension, diabetes, and atrial fibrillation presented to the Urology clinic with asymptomatic microscopic hematuria. His work up for hematuria included a negative cystoscopy and a computed tomography (CT) scan, which revealed what appeared to be a fluid collection around the left kidney with a perinephric infiltrative mass and two para-aortic enlarged lymph nodes.
November 2016: Urology Case Reports
Mariko Yasui, Teppei Morikawa, Tohru Nakagawa, Jimpei Miyakawa, Daichi Maeda, Yukio Homma, Masashi Fukayama
Both small cell carcinoma and sarcomatoid carcinoma of the urinary bladder are highly aggressive tumors, and a concurrence of these tumors is extremely rare. We report a case of urinary bladder cancer with small cell carcinoma as a predominant component, accompanied by sarcomatoid carcinoma and conventional urothelial carcinoma (UC). Although the small cell carcinoma component had resolved on receiving chemoradiotherapy, rapid growth of the residual tumor led to a fatal outcome. A 47-year-old man presented with occasional bladder irritation and had a 2-year history of asymptomatic hematuria...
September 2016: Pathology, Research and Practice
Win Shun Lai, James Ellenburg, Mark E Lockhart, Peter N Kolettis
OBJECTIVE: To assess the costs associated with incidental extraurinary findings on computed tomography urogram (CTU) in patients with asymptomatic microscopic hematuria. MATERIALS AND METHODS: A retrospective review was performed to identify all CTUs performed for asymptomatic microscopic hematuria at our institution from 2012 to 2014. All genitourinary (GU) and incidental extraurinary findings were documented. Further clinical follow-up to May 2015 was reviewed to determine if any referrals, tests, imaging, and/or procedures were ordered based on the initial CTU...
September 2016: Urology
Hae Min Lee, Ji In Hyun, Ji-Won Min, Kyungsoo Lee, Yong Kyun Kim, Euy Jin Choi, Ho Cheol Song
The increasing interest in healthcare and health screening events is revealing additional cases of asymptomatic isolated microscopic hematuria (IMH). However, a consensus of the evaluation and explanation of the IMH prognosis is controversial among physicians. Here, we present the natural course of IMH together with the pathological diagnosis and features to provide supportive data when approaching patients with IMH. We retrospectively evaluated 350 patients with IMH who underwent a renal biopsy between 2002 and 2011, and the pathological diagnosis and chronic histopathological features (glomerulosclerosis, interstitial fibrosis, and tubular atrophy) were reviewed...
June 2016: Journal of Korean Medical Science
R Brugnano, R Del Sordo, C Covarelli, E Gnappi, S Pasquali
Immunoglobulin (Ig)M nephropathy (IgMN), known since 1978, is a very controversial clinicopathological entity characterized by IgM diffuse deposits in the mesangium at immunofluorescence whereas light microscop identifies minimal glomerular lesion, hypercellularity and expansion of the mesangium or sclerotic focal, segmental lesion. Clinically, it is a nephrotic syndrome, especially in pediatric patients, or asymptomatic proteinuria and/or isolated hematuria. These characteristics narrowly define IgMN between minimal change disease and focal segmental glomerulosclerosis, so it is not often recognized as a separate pathology...
August 2016: Journal of Nephrology
Matthew Nielsen, Amir Qaseem
BACKGROUND: The presence of blood in the urine, or hematuria, is a common finding in clinical practice and can sometimes be a sign of occult cancer. This article describes the clinical epidemiology of hematuria and the current state of practice and science in this context and provides suggestions for clinicians evaluating patients with hematuria. METHODS: A narrative review of available clinical guidelines and other relevant studies on the evaluation of hematuria was conducted, with particular emphasis on considerations for urologic referral...
April 5, 2016: Annals of Internal Medicine
Stefanie Weber, Katja Strasser, Sabine Rath, Achim Kittke, Sonja Beicht, Martin Alberer, Bärbel Lange-Sperandio, Peter F Hoyer, Marcus R Benz, Sabine Ponsel, Lutz T Weber, Hanns-Georg Klein, Julia Hoefele
BACKGROUND: Alport syndrome (ATS) is a progressive hereditary nephropathy characterized by hematuria and proteinuria. It can be associated with extrarenal manifestations. In contrast, thin basement membrane nephropathy (TBMN) is characterized by microscopic hematuria, is largely asymptomatic, and is rarely associated with proteinuria and end-stage renal disease. Mutations have been identified in the COL4A5 gene in ATS and in the COL4A3 and COL4A4 genes in ATS and TBMN. To date, more than 1000 different mutations in COL4A5, COL4A3, and COL4A4 are known...
June 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Miho Okano, Masayoshi Yasui, Masaya Nishino, Yohei Hosoda, Junji Kawada, Ken-ichi Nagai, Yongkook Kim, Masaki Okuyama, Toshimasa Tsujinaka
A 77 year-old man with asymptomatic microscopic hematuria underwent a cystoscopic examination, which identified a broad-based papillary tumor at the cervix of the bladder. Adenocarcinoma was detected in the biopsy specimen. MRI and CT examination showed a huge papillary tumor of the bladder invading the inner lobe of the prostate. In addition, the wall of the lower rectum exhibited thickening with enlargement of the regional lymph nodes. Endoscopy disclosed a hemi-circular rectal tumor and pathological examination revealed adenocarcinoma, the profile of which was similar to the bladder tumor...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Joe Devasahayam, Gowrishankar Erode-Singaravelu, Zeenat Bhat, Tony Oliver, Arul Chandran, Xu Zeng, Paramesh Dakshinesh, Unni Pillai
C1q nephropathy is a rare glomerular disease with characteristic mesangial C1q deposition noted on immunofluorescence microscopy. It is histologically defined and poorly understood. Light microscopic features are heterogeneous and comprise minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), and proliferative glomerulonephritis. Clinical presentation is also diverse, and ranges from asymptomatic hematuria or proteinuria to frank nephritic or nephrotic syndrome in both children and adults...
2015: Analytical Cellular Pathology (Amsterdam)
Dae-Kyoon Yim, Sang-Taek Lee, Heeyeon Cho
IgA nephropathy usually presents as asymptomatic microscopic hematuria or proteinuria or episodic gross hematuria after upper respiratory infection. It is an uncommon cause of end-stage renal failure in childhood. Pulmonary hemorrhage associated with IgA nephropathy is an unusual life-threatening manifestation in pediatric patients and is usually treated with aggressive immunosuppression. Pulmonary hemorrhage and renal failure usually occur concurrently, and the pulmonary manifestation is believed to be caused by the same immune process...
October 2015: Korean Journal of Pediatrics
Megan S Bradley, Marcella G Willis-Gray, Cindy L Amundsen, Nazema Y Siddiqui
PURPOSE: In 2012 the AUA (American Urological Association) released a revision of the asymptomatic microscopic hematuria guidelines. Our study objectives were to assess adherence to these guidelines and describe the prevalence of urinary tract malignancy in postmenopausal women at our institution. MATERIALS AND METHODS: This is a cross-sectional analysis of women older than 55 years evaluated at the Division of Urogynecology or Urology from August 2012 to August 2014 for a diagnosis of asymptomatic microscopic hematuria...
April 2016: Journal of Urology
Sang Hyub Lee, Dong-Gi Lee
Nutcracker syndrome (NCS) is an uncommon vascular abnormality that causes a variety of symptoms that range from asymptomatic microscopic hematuria to severe pelvic congestion. Congenital portosystemic shunt (CPSS) is an extremely rare anomaly that causes serious complications. Many cases of NCS and CPSS that have presented separately have been reported, but no cases of concomitant NCS and CPSS have been reported. We present a case of intermittent macroscopic hematuria in a patient with both NCS and CPSS. We diagnosed NCS on pressure gradient between the left renal vein (LRV) and the inferior vena cava...
June 2015: Pediatrics International: Official Journal of the Japan Pediatric Society
Justin Ziemba, Thomas J Guzzo, Parvati Ramchandani
Asymptomatic microscopic hematuria (AMH) is relatively common in clinical practice but the etiology remains unclear in the majority of patients; it is rarely related to genitourinary malignancies. The 2012 guidelines of the American Urological Association recommend an evaluation after a single positive urinalysis with mandatory upper tract evaluation in all patients, preferably with CT urography (CTU). The likelihood of detecting significant upper track abnormalities, particularly malignancies is low with CTU, while incidental extraurinary abnormalities are often found, the majority of which are not clinically significant...
August 2015: Academic Radiology
S Tonyali, Y Erdem, S R Yilmaz, I Erkan, F T Aki
BACKGROUND: There is an expanding gap between the number of patients listed for kidney transplantation and the number of kidney transplantations performed annually. The use of sensitive imaging methods results in increased discovery of many urologic asymptomatic problems, such as urolithiases, renal cysts, and solid renal masses. This result has brought the question of whether all donors with these urologic disorders should be rejected for donation. METHODS: We retrospectively analyzed donor and recipient records of all living kidney transplantations performed from 2004 to 2014...
June 2015: Transplantation Proceedings
Kyosuke Matsuzaki, Ryoichi Imamura, Toshichika Iwanishi, Masahiro Nakagawa, Go Tanigawa, Koichi Tsutahara, Kohki Shimazu, Hiroaki Fushimi, Toyonori Tsuzuki, Seiji Yamaguchi
A 42-year-old woman was referred to our hospital with a chief complaint of asymptomatic gross hematuria. Computed tomography revealed a 4-cm tumour in the left kidney and radical nephrectomy was performed. Microscopically, the tumour was completely necrotic and consisted of nests of cells with abundant cytoplasm and large nuclei. Immunohistochemical analysis indicated complete infarction of the chromophobe renal cell carcinoma. Two years after surgery, the patient remained recurrence-free.
January 2015: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Koh-Wei Wong
We report a case of renal cell carcinoma diagnosed after a patient was treated successfully with intravenous cyclophosphamide for her active proliferative lupus nephritis (classes III and V). After the intravenous cyclophosphamide regimen, the patient was asymptomatic with persistent microscopic haematuria, and no proteinuria. The renal cell carcinoma was located on the left kidney; incidentally, this was where the initial renal biopsy was done to diagnose lupus nephritis.
2015: BMJ Case Reports
Minyong Kang, Sangchul Lee, Seong Jin Jeong, Sung Kyu Hong, Seok-Soo Byun, Sang Eun Lee, Chang Wook Jeong
OBJECTIVE: To provide detailed characteristics of asymptomatic microscopic hematuria, as well as to identify the significant predictors of detecting underlying diseases of asymptomatic microscopic hematuria, by evaluating a large Korean population. METHODS: We obtained data from healthy adults over the age of 20 years who underwent the health-screening program from 2005 to 2010 at Seoul National University Bundang Hospital, resulting in 56,632 participants included in the analysis...
April 2015: International Journal of Urology: Official Journal of the Japanese Urological Association
Abdulla A Alharthi, Azza A Taha, Awatif E Edrees, Ali N Elnawawy, Azza H A Abdelrahman
OBJECTIVES: To estimate the frequency of urinary problems among preschool children. METHODS: In this cross-sectional study, 1000 preschool asymptomatic children attending the outpatient clinics of the Children's Hospital, Taif, Kingdom of Saudi Arabia between August 2013 and December 2013 were subjected to dipstick urine analysis. Microscopic examination was performed for the abnormal dipstick samples, and children with hematuria were investigated for kidney function...
December 2014: Saudi Medical Journal
Victoria J Sharp, Daniel K Lee, Eric J Askeland
Urinalysis is useful in diagnosing systemic and genitourinary conditions. In patients with suspected microscopic hematuria, urine dipstick testing may suggest the presence of blood, but results should be confirmed with a microscopic examination. In the absence of obvious causes, the evaluation of microscopic hematuria should include renal function testing, urinary tract imaging, and cystoscopy. In a patient with a ureteral stent, urinalysis alone cannot establish the diagnosis of urinary tract infection. Plain radiography of the kidneys, ureters, and bladder can identify a stent and is preferred over computed tomography...
October 15, 2014: American Family Physician
Kathryn H Pade, Deborah R Liu
Hematuria is defined as an abnormal number of red blood cells in urine. Even a tiny amount of blood (1 mL in 1000 mL of urine) is sufficient to make urine appear pink or red. In the pediatric population, the majority of etiologies are benign and often asymptomatic. However, hematuria may also be a sign of renal pathology, local infection, or systemic disease. Hematuria can be differentiated into 2 categories: macroscopic hematuria (visible to the naked eye) and microscopic hematuria (> 5 red blood cells/high-powered field on urinalysis)...
September 2014: Pediatric Emergency Medicine Practice
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