Renal biopsy and family studies in 65 children with isolated hematuria.
We have investigated 65 children with isolated hematuria persisting for at least a year. Renal biopsy specimens were studied by light microscopy, electron microscopy and immunofluorescence with antisera specific against basement membrane components. The majority of the biopsies (62/65) showed variable histologic abnormalities. Four categories could be distinguished on combined histological and clinical criteria: Alport syndrome (n = 8), benign hematuria (n = 33, familial in 23), IgA nephropathy (n = 16) and increase in mesangial cells and matrix (n = 5). On the basis of our results, we suggest that a renal biopsy can establish diagnosis and prognosis in those children with isolated hematuria where the family history is negative. If the family has adult male individuals with isolated hematuria, a biopsy can usually be avoided, since this family history effectively excludes Alport syndrome. The use of antisera against basement membrane components did not allow a differentiation between Alport syndrome and benign hematuria. Goodpasture serum immunofluorescence was variable in the former and normally present in the latter.
Schröder
C H
CH
Department of Paediatrics, St. Radboud Hospital, University of Nijmegen, The Netherlands.
Bontemps
C M
CM
Assmann
K J
KJ
Schuurmans Stekhoven
J H
JH
Foidart
J M
JM
Monnens
L A
LA
Veerkamp
J H
JH
D001485:Basement Membrane / Q000473:pathology; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006417:Hematuria / Q000235:genetics / Q000473:pathology*; D006801:Humans; D007678:Kidney Glomerulus / Q000473:pathology*; D008297:Male; D008854:Microscopy, Electron; D008856:Microscopy, Fluorescence; D009394:Nephritis, Hereditary / Q000235:genetics / Q000473:pathology*; D010375:Pedigree