Differential Diagnosis for Recurrent Hematuria with Cystitis Glandularis
Single Most Likely Diagnosis
- Chronic Cystitis: This is the most likely diagnosis given the patient's history of recurrent hematuria and the finding of cystitis glandularis on cystoscopy. Cystitis glandularis is a type of chronic cystitis characterized by the formation of gland-like structures in the bladder mucosa, often associated with chronic inflammation and irritation.
Other Likely Diagnoses
- Bladder Cancer: Although less likely than chronic cystitis, bladder cancer is a possible cause of recurrent hematuria and should be considered, especially in the context of cystitis glandularis, which can sometimes be a precursor to or associated with malignancy.
- Interstitial Cystitis: This condition, also known as painful bladder syndrome, can cause recurrent hematuria and could be considered in the differential diagnosis, especially if the patient reports symptoms of pelvic pain and urinary frequency.
Do Not Miss Diagnoses
- Bladder Tuberculosis: Although rare, bladder tuberculosis can cause chronic cystitis and hematuria. It's crucial not to miss this diagnosis due to its significant implications for treatment and public health.
- Sickle Cell Disease-related Hematuria: Given the patient's African-American background, sickle cell disease or trait should be considered, as it can cause hematuria due to sickling in the hypoxic environment of the kidney medulla.
Rare Diagnoses
- Schistosomiasis: This parasitic infection can cause bladder disease, including cystitis and hematuria, and is more common in certain parts of the world. It would be a rare consideration in this context but should be kept in mind if the patient has a relevant travel history.
- Malacoplakia: A rare inflammatory condition that can affect the bladder and cause hematuria, malacoplakia is associated with chronic infection and an abnormal immune response. It's an uncommon condition but could be considered in the differential diagnosis of cystitis glandularis.