Differential Diagnosis for Hematuria in a 5-year-old
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): This is a common cause of hematuria in children, especially in girls. The presence of blood in the urine, along with symptoms like dysuria, frequency, and abdominal pain, points towards a UTI.
Other Likely Diagnoses
- Kidney Stones: Although less common in children than in adults, kidney stones can cause severe pain and hematuria. A family history of kidney stones or certain metabolic disorders increases the likelihood.
- Glomerulonephritis: Post-streptococcal glomerulonephritis is an immune-mediated condition that can occur after a streptococcal infection, leading to hematuria, proteinuria, and renal dysfunction.
- Trauma: Accidental injuries can cause hematuria, especially if the child has fallen onto their abdomen or back, potentially injuring the kidneys or urinary tract.
Do Not Miss Diagnoses
- Wilms Tumor: A rare but critical diagnosis, Wilms tumor is a type of kidney cancer that can present with hematuria, abdominal mass, or hypertension. Early detection is crucial for effective treatment.
- Vasculitis (e.g., Henoch-Schönlein Purpura): This condition can cause hematuria along with purpura, arthritis, and abdominal pain. It's essential to recognize and treat promptly to prevent long-term complications.
- Sickle Cell Disease or Trait: In children with sickle cell disease, sickling of red blood cells can lead to renal infarction and hematuria. Even those with sickle cell trait can experience renal complications under certain conditions.
Rare Diagnoses
- Alport Syndrome: A genetic disorder affecting the type IV collagen in the kidneys, ears, and eyes, leading to hematuria, progressive kidney disease, and hearing loss.
- Nephrocalcinosis: A condition characterized by the deposition of calcium salts in the renal tissue, which can cause hematuria, among other symptoms.
- Renal Vein Thrombosis: More common in neonates but can occur in older children, especially those with nephrotic syndrome or dehydration, leading to hematuria and acute kidney injury.