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Idiopathic hypercalciuria preceding IgA nephritis in a child with recurrent hematuria
Velibor Tasic1, Petar Korneti, Nadica Ristoska-Bojkovska
1Department of Pediatric Nephrology, Clinic for Children's Diseases, Medical School, Skopje, Macedonia. vtasic@freemail.com.mk
Insights
Idiopathic hypercalciuria in children can present with gross hematuria. Even after treatment, recurrent hematuria may indicate underlying glomerular disease, such as IgA nephropathy.
Area of Science:
- Pediatric Nephrology
- Urology
- Internal Medicine
Background:
- Idiopathic hypercalciuria is a common cause of hematuria in children.
- Gross hematuria, especially recurrent episodes, warrants thorough investigation.
Observation:
- A 5-year-old boy presented with gross hematuria, initially attributed to idiopathic hypercalciuria.
- Despite normalized calciuria, the patient experienced recurrent episodes of gross hematuria.
- Urinary protein analysis suggested a glomerular origin for the hematuria.
Findings:
- Renal biopsy revealed IgA nephropathy as the underlying cause.
- The co-occurrence of hypercalciuria and IgA nephropathy in this case is considered coincidental.
- Both conditions are frequently observed in pediatric hematuria cases.
Implications:
- Children with well-controlled hypercalciuria experiencing recurrent gross hematuria require evaluation for glomerular diseases.
- This case highlights the importance of considering glomerular pathology even when hypercalciuria is present.
- Early diagnosis and management of IgA nephropathy are crucial for pediatric kidney health.
Abstract:
A 5-year-old boy was investigated after an episode of gross hematuria of non-glomerular origin and was found to have idiopathic hypercalciuria. Despite normalization of calciuria he had recurrent attacks of gross hematuria. Since SDS-PAGE analysis of urinary proteins indicated a glomerular origin of hematuria, a renal biopsy was performed and revealed IgA nephropathy. We believe that association of hypercalciuria and IgA nephropathy is by chance, since both are frequently found in children with hematuria. Also, we recommend all children with well-controlled hypercalciuria who experience further attacks of gross hematuria be evaluated for glomerular disease.