title: Hypercalciuria as a cause of genital bleeding in a 6-year-old girl.
abstract: OBJECTIVE
  To document an unusual cause of genital bleeding in a 6-year-old girl.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Outpatient pediatric gynecology clinic in a tertiary care hospital.
  
  
  RESULTS
  Clinical presentation of a case of genital bleeding secondary to hypercalciuria in a 6-year-old female. Gynecologic investigations were negative. There were hematuria on urinalysis and an elevated calcium-to-creatinine ratio on initial presentation; however, no evidence of urolithiasis was found on ultrasound. In the context of negative investigations and persistent episodes of bleeding, the hypercalciuria was treated with hydrochlorothiazide. Normalization of calciuria was associated with the end of genital bleeding episodes.
  
  
  CONCLUSIONS
  Hypercalciuria with microcrystals and urethral irritation should be considered as part of the differential diagnosis for genital bleeding in girls.
authors.affiliation: Department of Obstetrics and Gynecology, University of Ottawa, Ontario, Canada.
authors.forename: Edith E
authors.initials: EE
authors.lastname: Valcourt
authors.forename: Nathalie A
authors.initials: NA
authors.lastname: Fleming
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Weiler
mesh_terms: D002648:Child; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006417:Hematuria / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use; D053565:Hypercalciuria / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
chemical_list: D004232:Diuretics; D006852:Hydrochlorothiazide