Causes and outcomes of asymptomatic gross haematuria in children.
OBJECTIVE
Although asymptomatic gross haematuria (GHU) is relatively common in children, its causes and clinical outcomes are not clearly defined.


METHODS
Children with asymptomatic GHU were examined and work-up was performed. Patients with recurrent GHU with proteinuria, or significant proteinuria, were considered for renal biopsy.


RESULTS
The male : female ratio of all patients was 190:75, and the median age at onset of GHU was 6.4 years. Patients were grouped according to abnormalities on initial evaluation as follows: idiopathic (50%), proteinuria (21%), hypercalciuria (14%), sonographic abnormality (7%), hypocomplementaemia (4%), familial (3%), and bleeding tendency (2%). Of patients with idiopathic GHU, 38% had a single episode, and of these, 34% had persistent microscopic haematuria, which resolved on follow-up. Late onset proteinuria was accompanied in 11% of patients with recurrent GHU. Nutcracker syndrome was diagnosed in one patient with recurrent idiopathic GHU. Of patients with recurrent GHU, 89% had no proteinuria on follow-up, and GHU and microscopic haematuria resolved in 97% and 89%, respectively.


CONCLUSIONS
Our work-up protocol was useful for diagnosis and follow-up planning. Asymptomatic GHU in children was most commonly the idiopathic form. Overall, long-term prognosis appears to be benign; however, careful follow-up is essential.
Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
Joo Hoon
JH
Lee
Hae-Won
HW
Choi
Yoon Jung
YJ
Lee
Young Seo
YS
Park
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009394:Nephritis, Hereditary / Q000150:complications; D012189:Retrospective Studies
glomerulonephritis; haematuria; immunoglobulin A nephropathy; paediatric nephrology; proteinuria