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  1. coreraeg
  2. General Nephrology Questions
  3. Tuesday, 24 April 2012
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My now 8 year old son was diagnosed with Post Streptoccal Glomerulonephritis over a year ago.  His hematuria went away after about 3 months (when his tonsils were finally taken out).  It's now 1 year later and he starting experiencing urinary frequency and then gross hematuria.  The gross hematuria has been going on now consistently for a week.  No pritenuria & BP is normal.  Peditarician says not to worry and doesn't want to refer him to a Nephrologist.  Should I push the issue?
Responses (6)
Accepted Answer Pending Moderation
Hello,

It is common for urinary abnormalities to persist after PSGN. Three clarification questions:

  1. When you say gross hematuria, do you mean frank blood or tea/cola colored urine?
  2. Is your son's kidney function normal?
  3. Did your son ever have a kidney biopsy?

Regards,

Jordan
  1. more than a month ago
  2. General Nephrology Questions
  3. # 1
Accepted Answer Pending Moderation
1. Started as tea colored and now is bright red.
2. Yes normal kidney function
3. No biopsy
  1. more than a month ago
  2. General Nephrology Questions
  3. # 2
Accepted Answer Pending Moderation
Thanks,

Did the urine color ever normalize after the initial bout? Secondly, did the change in urine color coincide with an upper respiratory tract infection (i.e. common cold)?

Jordan
  1. more than a month ago
  2. General Nephrology Questions
  3. # 3
Accepted Answer Pending Moderation
Yes, after the initial bout his urine normalized (immediately after tonsillectomy was performed). It was normal for 10 months. I don't believe a respiratory tract infection coincined this time, but it is possible since his allergies were kind of bad this spring and I could've confused them with a cold. The hematuria has occurred daily for 2 weeks now. Several urinalyses have been ordered and everything looks fine except for RBCs are elevated, of course. He's been complaining a lot of stomach and head aches. Pediatrician doesn't think these aches are related and that hematuria will resolve soon. Blood pressure is also normal. Thoughts?
  1. more than a month ago
  2. General Nephrology Questions
  3. # 4
Accepted Answer Pending Moderation
There would be a differential diagnosis here that would include other things besides PSGN, say for example, IgA nephropathy. If protein excretion is normal and as renal function is normal, the role for biopsy would be to clarify the diagnoses; treatment is likely not required. So waiting for the hematuria to resolve as your pediatrician has suggested would likely not result in any harm and may avoid a biopsy. Having said this, a consultation with a nephrologist would not be wrong and s/he could shed light with the help of a couple of additional lab tests. Two outstanding parameters would be to know urinary protein excretion and serum complement levels.
  1. more than a month ago
  2. General Nephrology Questions
  3. # 5
Accepted Answer Pending Moderation
Thanks for your response. We are seeing a pediatric nephrologist next week. Based on my own research, I was wondering about IgA nephropathy. He is still experiering daily hematuria, it's been going on now for almost a month.
  1. more than a month ago
  2. General Nephrology Questions
  3. # 6
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