Differential Diagnosis for a 3-month-old Baby Boy with Frank Hematuria and Protein in the Urine
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): Although the baby is afebrile, UTIs can present without fever in infants. The presence of frank hematuria and proteinuria increases the likelihood of a UTI.
Other Likely Diagnoses
- Vesicoureteral Reflux (VUR): This condition can cause urinary stasis, leading to infection and subsequent hematuria and proteinuria.
- Renal Vein Thrombosis: Although less common, it can cause hematuria and proteinuria, especially in dehydrated or septic infants.
- Nephrocalcinosis: This condition can cause microscopic or gross hematuria and may be associated with proteinuria.
Do Not Miss Diagnoses
- Posterior Urethral Valves: A congenital anomaly that can cause obstructive uropathy, leading to renal damage and potentially life-threatening complications if left untreated.
- Congenital Nephrotic Syndrome: A rare condition that can cause massive proteinuria, leading to hypoproteinemia and potentially life-threatening complications.
- Wilms Tumor: A rare pediatric malignancy that can cause hematuria and abdominal mass, although it is less common in infants under 6 months.
Rare Diagnoses
- Alport Syndrome: A genetic disorder that affects the type IV collagen in the kidneys, causing hematuria, proteinuria, and potentially progressive kidney disease.
- Hemolytic-Uremic Syndrome (HUS): A condition characterized by hemolytic anemia, acute kidney injury, and thrombocytopenia, which can cause hematuria and proteinuria.
- Cystic Kidney Diseases: A group of genetic disorders that can cause cystic changes in the kidneys, leading to hematuria, proteinuria, and potentially progressive kidney disease.