Topics Discussed: hematology; hematuria; urology and nephrology.
Excerpt:"I. Definition. Hematuria is the presence of gross or microscopic blood in the urine. More than 5–10 red blood cells per high-power field (HPF) are usually considered significant. Some authors recommend two of three urinalyses show microhematuria before evaluation is undertaken. A red-stained diaper usually signifies hematuria but may be due to bile pigments, porphyrins, or urates.
II. Incidence. Hematuria is not a common problem in newborns. Transient hematuria is common in critically ill neonates. Normal newborns do not have hematuria.
III. Pathophysiology. Hematuria may originate from the glomeruli, renal tubules and interstitium, or urothelium. Common causes include:
- A. Trauma. Birth or iatrogenic, such as bladder aspiration or catheterization.
- B. Vascular. Renal vein or renal artery thrombosis, hyperosmolar infusions into umbilical catheters.
- C. Renal. Renal cortical or medullary necrosis, neonatal glomerulonephritis (most commonly caused by syphilis).
- D. Infection.
- E. Neoplasms. Rhabdomyosarcoma, Wilms tumor, neuroblastoma, or nephroblastoma, urinary tract obstruction (urolithiasis..."
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