Abstract
Objective: To evaluate the clinical and etiological profile of hemauria in children and to describe the course of illness till the end of one year
Methodology: Prospective follow up study of a case series in a tertiary care teaching hospital in Kerala, South India during the period January2001-2002. Data collection and evaluation were done during initial workup and follow up assessment and relevant investigation were done during subsequent visits.
Results: The study population included 100 children admitted with hematuria during the period of study. Hematuria was found to be a major problem of school going children of age 6-12 years (57%) with slight female preponderance (52%). Highest incidence was occurred in August and December. Majority belong to low socioeconomic status (42%) and were residing around Thiruvananthapuram district. At the time of admission 60% diagnosed as PIGN,22% as microscopic hematuria of which UTI-9%,infective endocarditis -1%, Ideopathic (12%) (7 had persistent hematuria on follow up). remaining 18% were contributed by septicemia, snakebite, HSP, HUS, Abdominal mass etc.75 of them followed up for one year. During follow up among the non biopsied (40) cases, Post infectious glomerulonephritis (PIGN) (59%), sepsis-5(12%),UTI-5(12%), Snake bite-3(7%),nephrolithiasis-2(5%),Ideopathic-2(5%) were there. Renal Biopsy was done for 35 cases (46.6%). Among the biopsied cases IGA nephropathy-8(23%)(all between 9-12 years), SLE-6(17%), PIGN-4(11.4%), DPGN-4(11.4%), HUS-3(8.5%), HSP-3(8.5%), FSGS-3(8.5%), Thin basement membrane disease-2 (5.7%), ATN-2(5.7%)
Conclusion: Among the 3.8% total admissions of hematuria PIGN was the leading cause(59% non biopsied cases and 11.4% biopsied cases)followed by IGA Nephropathy(23%) and SLE (17%). 60% of hematuria resolved by one year & there were no deaths due to hematuria till the end of 12 month follo.
References
- Denver G. Clarck. Current pediatrics nephrology symposium 2000 volume 10-116-121
- Srevastava R.N. Bagga A-.CME-Asymptomatic hematuria and proteinuria, Journal of Indian pediatrics -Vol 29, April 1992. p523-528.
- Hiren P. Patel MD, John J Bissler MD. Pediatric Clinics of North America Vol 48, number 6. Dec 2001
- Richard s. Trompeter T Martin Barratt. Edelman- Pediatric kidney diseases II edition volume 1 Section 4 p317-327
- Jerry M. Bergstein Behrman Kliegman and Jenson.Nelson Text Book of Pediatrics - 16th edition Vol 2.p1577-1590.
- Indian Pediatric Nephrology Group, Indian Academy of Pediatrics Consensus statement on Evaluation Hematuri Indian Pediatrics 2006; 43:965-973)\
- Meadow SR. Hematuria. In: Postlethwaite RJ, editor. Clinical Pediatric Nephrology. 2nd ed. Oxford: Butterworth-Heinemann; 199. P. 1-14.
- Feld LG, Waz WR, Perez LM, Joseph DB, Feld LG, Waz WR, et al. Hematuria: an integrated medical and surgical approach. Pediatr Clin North Am 1997; 44: 1191-1210.
- Vijayakumar M, Nammalwar BR. Diagnostic approach to a child with hematuria. Indian Pediatr 1998; 35: 525-532.
- Zainal D, Baba A, Mustaffa BE- screening proteinuria and hematuria in Malaysian children.
- Wierzchowska E, czyzocska J, Stepriewskis. Causes of hematuria in children with special consideration of urolithiasis 1997, 54 (7-8) 554-7
- Emre S, Bilge J, SirinA, KiliCastlan J, Nayer A, Oketem F Wysal V, Nephron 2001 Feb 87(2):118-26
- Ghio L, Edefonte A, Cohen E, Giani M Italian article, Pediatric Med Chir: 1986, May-June 8(3): 325-8.
- Yoshikawa N, Ito H, Yoshihara S, Nakahara C, Yoshiya K, Hasegawa Clinical course of IgA nephropathy in children. J. Pediatrics 1987, 110:555 - 560.
- Kher KK, Makker SP Moorthy B. International Journal of Pediatric nephrology 1983 March 4(1):11-8.
- Rimediotti MJ, BianChetti MG, Penzien JM Schweiz, Med Wochenschr - 1992, Nov 21, 122 (47) 1803-9
- Yalacinkaya F, Ince E, Turner N, Ekim M, Turkish Journal of Pediatrics, 1992, Jul-Sep 34(3)-135-44.
- Parekh DJ, Pope JC 4th, Adams MC, Brock JW 3rd Association of an increased urinary' ca- creatinine ratio and asymptomatic gross and microscopic hematuria, Journal of urology 2002 Jan; 167 (1); 272-4.
- Wood EG- Asymptomatic hematuria in child hood a practical approach to evaluation. Indian Journal of pediatrics- 1999 March-April 66 (2)- 207
- Giani M, Damiani B, Ghioh, Spano M, Edefonte, Clinical features and prognosis in child hood IgA nephropathy. Ren Fail 1994; 629-36
- Takahashi I, Suzuki T, Takada G, Simada K. Japanese Article. Asymptomatic hematuria and proteinuria in children under 3 years of age. Clinicopathological evaluation. Department of pediatrics, Akita University, School of Medicine, Japan - 1994 June 36 (6): 715-21.
Corresponding Author
Karthika Gopan.P
TRWA-5, Nrithya, Thaliyil, Karamana PO, TVM, Kerala, INDIA, Pin-695002
Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mob-9947064300
DOI: https://dx.doi.org/10.18535/jmscr/v6i5.40
