Causes and diagnostic significance of macroscopic hematuria in children and young adults

Background: Hematuria is common complaint brings patients to a physician. Macroscopic hematuria can be transient or persistent, and it may or may not associate with significant urinary system abnormalities. Objective: The objective of this study is to determine the major causes of macroscopic hematuria in ages less 20 years. Patients and Method: Descriptive case series study carrried out as a collaborative study in Tripoli during Januray 2013 - December 2014. Patients who presented with macroscopic hematuria file were studied retrospectively for gender, age, possible associated diseases as glomerulalar diseases, urinary tract infection (UTI), and others. Results: Out of 126 patients had macroscopic hematuria, 107 patients had the required data that achieved the study protocol. They were 72 cases (67.28%) males and 35 cases (32.71%), and their age ranged between (7 and 20 years). Macroscopic hematuria was more frequently reported at the age 7–13 years, and it was reported in (58.87%) due to the glomerular lesion, and in (41.12%) due to nonglomerular cause. Acute poststreptococcal glomerulonephritis (AGN) was the most common cause of macroscopic hematuria (53.27%), UTI was the second cause of macroscopic hematuria (28.97%), and renal stone was (9.34%) of total causes. Macroscopic hematuria due to trauma reported in 3 cases (6.8%), and in 5 cases (2.27%) due to IgA nephropathy. Conclusion: AGN and UTI are common causes of macroscopic hematuria. Urine microscopic examination is essential to differentiate between them before preceding to the other complicated, expensive, and invasive investigations.