Differential Diagnosis for Hematuria in a 76-year-old
Single Most Likely Diagnosis
- Benign Prostatic Hyperplasia (BPH): Given the age of the patient, BPH is a common condition in elderly men that can cause hematuria due to urinary tract obstruction and subsequent bladder outlet obstruction.
Other Likely Diagnoses
- Urinary Tract Infections (UTIs): Elderly individuals are more prone to UTIs, which can present with hematuria, especially if the infection involves the kidneys (pyelonephritis).
- Kidney Stones: While not exclusive to the elderly, the risk of developing kidney stones increases with age, and they can cause hematuria.
- Bladder Cancer: The risk of bladder cancer increases with age, and hematuria is a common presenting symptom.
Do Not Miss Diagnoses
- Renal Cell Carcinoma: Although less common than other causes of hematuria, renal cell carcinoma is a potentially life-threatening condition that requires early detection.
- Sepsis from a Urinary Source: In elderly patients, UTIs can quickly progress to sepsis, a life-threatening condition that requires immediate intervention.
- Aortic Aneurysm: A ruptured abdominal aortic aneurysm can cause hematuria and is a medical emergency.
Rare Diagnoses
- Alport Syndrome: A genetic disorder affecting the type IV collagen in the kidneys, ears, and eyes, leading to hematuria, but it typically presents earlier in life.
- Goodpasture Syndrome: An autoimmune disease causing glomerulonephritis and hematuria, which is rare and more commonly seen in younger individuals.
- Sickle Cell Disease: Can cause hematuria due to sickling in the kidneys, but it is typically diagnosed earlier in life due to other manifestations of the disease.