What causes hemolyzed blood in urinalysis (UA) with a 16-year-old female (F) presenting with dysuria?

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Differential Diagnosis for Hemolyzed Blood in UA with 16yo F with Dysuria

  • Single most likely diagnosis:
    • Urinary Tract Infection (UTI): This is the most likely diagnosis given the patient's symptoms of dysuria and hemolyzed blood in the urine. UTIs are common in young women and can cause hemolysis of red blood cells in the urine.
  • Other Likely diagnoses:
    • Kidney Stone: A kidney stone can cause dysuria and hematuria (blood in the urine), which may appear as hemolyzed blood in the UA. The stone can damage the urinary tract and cause bleeding.
    • Trauma: Trauma to the urinary tract, such as from a fall or accident, can cause hematuria and dysuria.
    • Menstrual Contamination: In a 16-year-old female, menstrual contamination of the urine sample is possible, which can cause hemolyzed blood in the UA.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Sickle Cell Disease: Although less common, sickle cell disease can cause hemolyzed blood in the urine due to sickling of red blood cells in the urinary tract.
    • Hemolytic Uremic Syndrome (HUS): HUS is a rare but life-threatening condition that can cause hemolyzed blood in the urine, and it is essential to consider it in the differential diagnosis.
    • Glomerulonephritis: This is an inflammation of the glomeruli in the kidneys, which can cause hematuria and proteinuria, and may appear as hemolyzed blood in the UA.
  • Rare diagnoses:
    • Alport Syndrome: A rare genetic disorder that affects the type IV collagen in the kidneys, causing hematuria and progressive kidney disease.
    • Goodpasture Syndrome: A rare autoimmune disease that causes inflammation in the kidneys and lungs, leading to hematuria and renal failure.
    • Thrombotic Thrombocytopenic Purpura (TTP): A rare blood disorder that can cause hemolyzed blood in the urine due to the formation of blood clots in small blood vessels.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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