Haematuria Differential Diagnoses
The presence of blood in the urine, or haematuria, can be caused by a variety of conditions affecting the kidneys, ureters, bladder, or urethra. Here's a categorized differential diagnosis for haematuria:
- Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): This is often the most common cause of haematuria, especially in women. UTIs can cause inflammation and irritation of the bladder or urinary tract, leading to bleeding.
- Other Likely Diagnoses
- Kidney Stones: Stones in the kidney or ureter can cause bleeding due to obstruction and irritation of the urinary tract.
- Benign Prostatic Hyperplasia (BPH): Enlargement of the prostate gland can cause urinary retention, leading to bleeding, especially in older men.
- Cystitis: Inflammation of the bladder, often due to infection, can cause haematuria.
- Do Not Miss Diagnoses
- Bladder Cancer: Although less common, bladder cancer is a critical diagnosis not to miss, as it can present with painless haematuria.
- Kidney Cancer: Similar to bladder cancer, kidney cancer can cause haematuria and is crucial to diagnose early.
- Sickle Cell Disease: In patients with sickle cell disease, haematuria can occur due to sickling in the kidney, which is a medical emergency.
- Rare Diagnoses
- Alport Syndrome: A genetic disorder affecting the type IV collagen in the kidneys, leading to haematuria and progressive kidney disease.
- Goodpasture Syndrome: An autoimmune disease causing inflammation in the kidneys and lungs, which can present with haematuria.
- Vasculitis: Inflammation of the blood vessels, such as in conditions like Wegener's granulomatosis, can cause haematuria due to kidney involvement.
Each of these diagnoses has a different set of risk factors, symptoms, and diagnostic approaches. A thorough medical history, physical examination, and appropriate diagnostic tests (such as urinalysis, imaging studies, and biopsy) are essential for determining the underlying cause of haematuria.