(From June 2017 Paediatric Pearls Newsletter)
Also see:
- Specific Gravity (in January 2017 newsletter pdf)
- pH ( in Feb 2017 newsletter pdf)
- Nitrites (in March 2017 newsletter pdf)
- Leucocytes (in April 2017 newsletter pdf)
Blood
- Red or brown urine does not always mean blood
- High false positive rate (eg. haemoglobinuria, myoglobinuria, concentrated urine, menstrual blood in the urine sample, rigorous exercise) so dipstick positive blood needs to be looked at under the microscope to accurately diagnose haematuria
- False negative possible if specific gravity is < 1007
- Significant haematuria is defined as ≥ 10 red blood cells (≥ 3 in adults) per high-power field in a properly collected and centrifuged urine specimen
- Isolated microscopic haematuria in a well child only really needs further investigation after 3 positive samples over a period of a few months
- Concomitant proteinuria, high BP or a palpable abdominal mass should be investigated promptly
- Possible causes of haematuria in children:
- UTI
- Viral infections
- Post streptococcal glomerulonephritis
- Trauma
- Henoch Schonlein Purpura
- Wilm’s tumour (median age 3.5 years)
Resources:
- http://lifeinthefastlane.com/investigations/urinalysis/
- http://labtestsonline.org.uk/understanding/analytes/urinalysis/ui-exams?start=1
- http://www.mdedge.com/ccjm/article/94892/nephrology/how-evaluate-dipstick-hematuria-what-do-you-refer
- http://www.rch.org.au/clinicalguide/guideline_index/Haematuria/