• Title/Summary/Keyword: Hematuria

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A Case Study on Korean Medicine Treatment for Unexplained Hematuria with Chronic Pelvic Pain (원인불명의 혈뇨를 호소하는 만성골반통 여성 환자에 대한 치험 1례)

  • Park, Nam-Chun;Kang, Na-Hoon;Kim, Joon-Ho;Yoo, Eun-Sil;Pak, Yeon-Kyoung;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bok
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.3
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    • pp.100-109
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    • 2016
  • Objectives: Hematuria can occur frequently for various reasons, but there are so many patients who suffered from unexplained hematuria. This study aims to report the clinical effect of Korean medicine on unexplained hematuria with chronic pelvic pain.Methods: The patient received Korean medicine therapies such as herbal medication, acupuncture, moxibustion, cupping therapy, and Korean medicine steam therapy (about 20 days).Results: Urine occult blood and urine micro red blood cell of the patient were noticeably reduced during the treatment. The clinical symptoms about chronic pelvic pain were also improved.Conclusions: This case shows that Korean medicine is effective on unexplained hematuria with chronic pelvic pain.

Long-term Prognosis of thin Glomerular Basement Membrane Nephropathy in Children: A Retrospective Single Center Study

  • Lim, Myung Hee;Bae, Hee Jung;Jang, Kyung Mi;Park, Yong Hoon
    • Childhood Kidney Diseases
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    • v.21 no.2
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    • pp.41-46
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    • 2017
  • Purpose: Thin glomerular basement membrane nephropathy (TBMN) is, along with the IgA nephropathy, the most common cause of asymptomatic hematuria in Korean children. TBMN is usually a benign renal disease not requiring treatment and is associated with a good prognosis, but some cases hematuria is indicative of a state of progressive renal insufficiency. We aimed to retrospectively evaluate clinical manifestations and renal prognosis of patients with TBMN. Methods: Among the 428 renal biopsies performed on children at Yeungnam University Hospital between January 2000 and February 2017, 167 patients were diagnosed as having TBMN. We retrospectively investigated 167 pediatric patients and identified 59 children with follow-up duration >3 years. Results: Among 59 patients, there were 33 boys and 26 girls. Mean age of onset of hematuria was $7.18{\pm}2.64$ years, and mean time from onset of disease until a renal biopsy was performed was $2.48{\pm}2.10$ years. There were no clinical features or laboratory findings among studied children to indicate decreased renal function during follow-up; however, one case progressed to chronic kidney disease (CKD) due to an unknown cause. There were seven patients among these related a positive family history of hematuria or renal insufficiency. Concluson: Although almost all patients had normal renal functions during follow-up, there were one patient who progressed to CKD and seven patients with family history of hematuria or renal insufficiency. Moreover, four among the 428 patients over 17 years underwent repeat renal biopsies, which showed results different from their earlier biopsies.Thus, large-scales studies may be required to determine long-term prognosis of TBMN in children, and further evaluation for Alport syndrome in TBMN cases is essential.

External Validation of a Clinical Scoring System for Hematuria

  • Lee, Seung Bae;Kim, Hyung Suk;Kim, Myong;Ku, Ja Hyeon
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6819-6822
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    • 2014
  • Background: The aim of this study was to evaluate the accuracy of a new scoring system in Korean patients with hematuria at high risk of bladder cancer. Materials and Methods: A total of 319 consecutive patients presenting with painless hematuria without a history of bladder cancer were analyzed, from the period of August 2012 to February 2014. All patients underwent clinical examination, and 22 patients with incomplete data were excluded from the final validation data set. The scoring system included four clinical parameters: age (${\geq}50$ = 2 vs. <50 =1), gender (male = 2 vs. female = 1), history of smoking (smoker/ex-smoker = 4 vs. non-smoker = 2) and nature of the hematuria (gross = 6 vs. microscopic = 2). Results: The area under the receiver-operating characteristic curve (95% confidence interval) of the scoring system was 0.718 (0.655-0.777). The calibration plot demonstrated a slight underestimation of bladder cancer probability, but the model had reasonable calibration. Decision curve analysis revealed that the use of model was associated with net benefit gains over the treat-all strategy. The scoring system performed well across a wide range of threshold probabilities (15%-45%). Conclusions: The scoring system developed is a highly accurate predictive tool for patients with hematuria. Although further improvements are needed, utilization of this system may assist primary care physicians and other healthcare practitioners in determining a patient's risk of bladder cancer.

The associations of Urinary Neutrophil Gelatinase-associated Lipocalin (NGAL) and Liver-type Fatty Acid-binding Protein (L-FABP) Levels with Hematuria in Children and Adolescents

  • Choi, Youngmin;Bin, Joong Hyun;Cho, Kyoung Soon;Lee, Juyoung;Suh, Jin-Soon
    • Childhood Kidney Diseases
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    • v.23 no.2
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    • pp.105-110
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    • 2019
  • Purpose: We sought to determine associations of urinary neutrophil gelatinase-associated lipocalin (NGAL) and liver-type fatty acid-binding protein (L-FABP), known markers of renal injury, with hematuria in children and adolescents. Methods: A total of 112 urine samples from 72 patients aged 2 to 18 years with hematuria were enrolled in this study. Urinary concentrations of NGAL and L-FABP were measured by ELISA and compared between subjects with and without proteinuria and between subjects with and without glomerulonephritis diagnosed by renal biopsy. Results: Urinary concentrations of NGAL and L-FABP/creatinine (Cr) in subjects with proteinuria were not significantly different from those in subjects without proteinuria. They were not significant different between subjects with and without glomerulonephritis either. However, both concentrations of urinary NGAL and L-FABP/Cr were positively associated with urinary protein to creatinine ratio. Their levels had a tendency to be increased when proteinuria developed at later visits in subjects with hematuria only at initial visits. Conclusion: Monitoring urinary NGAL and L-FABP levels in addition to conventional risk factors such as proteinuria and serum creatinine might improve the prediction of renal injury in pediatric patients with hematuria.

A Case Report of the Hemostatic Effect of Samchilgeun Powder (Panax Motoginseng) on Hematuria in a Patient Requiring Double Antiplatelet Therapy Due to Recurrent Cerebral Infarction (재발된 뇌경색으로 이중항혈소판요법 필수인 환자의 혈뇨에 대한 삼칠근말의 지혈효과 증례보고 1례)

  • Kim, Seo-hyun;Kang, Ji-hyeon;Kim, Jun-seok;Jang, Woo-seok
    • The Journal of Internal Korean Medicine
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    • v.43 no.5
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    • pp.909-917
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    • 2022
  • Objective: The purpose of this study was to investigate the effect of Samchilgeun powder (panax notoginseng) on the treatment of hematuria in a patient requiring double antiplatelet therapy due to recurrent cerebral infarction. Methods: The patient was treated with Samchilgeun powder (panax notoginseng) combined with Western medicine (an antiplatelet). Urinalysis was performed to observe hematuria and proteinuria levels, and blood tests were used to evaluate anemia levels. Results: After treatment, hematuria levels decreased without exacerbation of anemia and proteinuria and even recurrence of cerebral infarction. Conclusions: This study suggests that Samchilgeun powder (panax notoginseng) can effectively treat patients with hematuria requiring double antiplatelet therapy due to recurrent cerebral infarction, but further studies should be conducted.

A study of Diagnostic Significance of Simultaneous Examination of Proteinuria and Hematuria in the Urinary Mass Screening (집단뇨검사(Urinary mass screening) 방법으로 단백뇨와 혈뇨의 동시검사가 가지는 진단적 가치에 대한 연구)

  • Kim, Young-Kyoun;Lee, Chong-Guk
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.57-63
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    • 1999
  • Purpose : To evaluate the diagnostic significance of simultaneous examination of hematuria and proteinuria in the urinary mass screening for early detection ot incipient renal diseases. Method and Object : During the period of 4 months from August to December in 1997, we did urinary mass screening on students of first grade of high school (16 years aged group) nationwide together with Korean Association of Health(KAH). In the first screening test, Comber-10 $N^{(R)}$ M dipsticks were used to detect proteinuria, hematuria, pyuria and nitrite simultaneously. Total 26,508 students (16 years aged group) from 33 high schools in every province in Korea, respectively, complied to the urinary mass screening. After then, one high school in Seoul was selected to reveal the true incidence of incipient renal diseases among students who showed hematuria in the initial screening through intensive examinations. Those who had hematuria and/or proteinuria visited the Paik hospital, and underwent blood tests and ultrasonographic examinations. The results were evaluated. Results 1) The initial screening revealed that the prevalence of proteinuria, hematuria, pyuria and positive nitrite urine, were $0.73\%,\;2.69\%,\;0.23\%\;and\;0.03\%$, respectively. 2) The first urinary screening among 875 students from one high school in Seoul selected fir the second test showed proteinuria, hematuria, pyuria and positive nitrite urine, were $0.91\%,\;4.68\%,\;0.34\%\;and\;0\%$, respectively. a) Total 8 among 875 students showed proteinuria, but one of them had orthostatic proteinuria and those remaining 7 students had transient proteinuria. b) There were 41 students who had hematuria in the initial screening. Among 33 who complied the second test, only one student showed asymptomatic isolated hematuria and those remaining students were normal. Conclusion : 1) Because of high false positive hematuria rate in the urinary mass screening, it dosen't seem to be appropriate that hematuria screening using dipsticks be included in the urinary mass screening. 2) A unified organization is needed from the fret that so various results of urinary mass screening came out. 3) Positive rates of pyuria and nitrite were so low that validity of urinary mass screening for urinary tract infection needs more studies.

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Study UBC Inspection of the Over Result (UBC 검사의 이상결과에 대한 연구)

  • Park, Jun Mo;Yoo, Hye Jung;Kim, Han Chul;Han, Geul Soon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.101-106
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    • 2013
  • Purpose: As UBC IRMA is being tested, patients out of the reference value are reacting within the value again a few days later the urine collection tested, which causes the reliability of the test to decrease as a result. In this study, we can assume that the physiological changes in the factors would affect the results. The purpose of the study is to find out whether hematuria and proteinuria in the sample as well as the interval time (3 hours or more recommended) have affected the results. As a result, we could discover the changes in factors and increase the reliability of the test. Materials and Methods: 468 people (female: 249, male: 219) who came for the check-up were presented herein for medical examination from 2013.3.15 to 2013.1.2. Some people out of 468 who have reacted onto the reference value were divided into group low titer zone, ow-middle titer zone, and middle-high titer zone and tested for hematuria and proteinuria. During that period, 48 outpatients were asked to fill in a questionnaire regarding the urination interval time. The reagents used were (IDL Biotech AB, Sweden) and UBC IRMA. Results: Of the patients that are formed in the reference value of ($0.1-34.0{\mu}g/L$) turn out to be 52.7 years average age in their low concentration, ($mean{\pm}SD$) of the value of $0.10{\pm}0.02{\mu}g/L$. Among 80 people (50.8%, female: 49.2%), 16 patients (20%) have shown reaction to microscopic hematuria and 10 patients (12.5%) responded to proteinuria. In the average low concentration under 52.5 years of average age, 43 people (53%) have shown reaction to microscopic hematuria and 21 people (26.3%) are proteinuric patients out of 80 patients (male: 50.8%, female: 51.3%). In the middle high concentration of $11.8{\pm}4.82{\mu}g/L$ under the average age 51.7 years, 35 patients (53%) have responded to the microscopic hematuria and proteinuric patients are 26 people (39.3%) out of 66 people (men: 44%, women: 56%). In addition, in the concentration of $51.7{\pm}43.5{\mu}g/L$, some patients who get out of the reference value are observed as the average age of 52.0. 11 patients (78.6%) out of 14 (male: 35.7%, female: 64.3%) react to the microscopic hematuria. There show 6 people (42.8%) who turn out to be as proteinuric patients. As for the interval time, $1.67{\pm}3.71{\mu}g/L$ was the average value among 48 patients (female: 45.8%, male: 54.2%). Conclusion: We cannot see if proteinuria and hematuria directly affect abnormal results of inspection of 8,18 cytokeratin; however, we can find out that they statistically have an influence on highly generating UBC among several mechanisms. Also, although urination interval time was various every 15 minutes, we it does not affect these results.

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CT Evaluation of the Findings of Nutcracker Syndrome in Patients with Bladder Cancer after Radical Cystectomy and Ileal Neobladder Formation: A Correlation with Hematuria (근치적 방광적출 후 회장 신방광형성술을 시행받은 방광암 환자의 컴퓨터단층촬영: 호두까기 증후군 소견의 분석 및 혈뇨와의 관계)

  • Hae Min Shin;Joongyub Lee;Dong Hyeon Lee;Seung Hyup Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.409-417
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    • 2023
  • Purpose Patients with bladder cancer may show hematuria after radical cystectomy with ileal neobladder formation, causing anxiety regarding tumor recurrence. Here, we aim to show that the nutcracker syndrome (NCS) can be a cause of hematuria post-operation, and is a common, rather than a rare syndrome. Materials and Methods A retrospective review of contrast-enhanced abdominopelvic CT (CE-APCT) and urine analysis (UA) findings of 255 patients with bladder cancer who underwent radical cystectomy and ileal neobladder formation between 2011 and 2016 was performed. In the CE-APCT review, the left renal vein flow patterns were evaluated to determine the presence of NCS findings. In the UA review, patients were classified according to the percentage of UA tests with positive hematuria among the total number of UA tests. Results CT findings of NCS were present in 31.9% of the 135 patients. In the positive hematuria group, there were 26% more patients with NCS findings than those without. Conclusion NCS findings are prevalent even for bladder cancer patients after surgery, and there is a strong correlation between NCS findings and hematuria. Furthermore, the prevalence of NCS findings is much higher than urinary tract recurrence after the surgery.

Nutcracker Syndrome combined with Superior Mesenteric Artery Syndrome in a Pediatric Patient: A Case Report

  • Min, Kyung Wook;Lee, Oh Kyung;Kim, Mi Kyung
    • Childhood Kidney Diseases
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    • v.22 no.2
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    • pp.75-80
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    • 2018
  • Nutcracker syndrome is a phenomenon that the left renal vein (LRV) is pressed between the superior mesenteric artery (SMA) and the aorta. Clinical characteristics include gross or microscopic hematuria, orthostatic proteinuria, abdominal pain, and back pain. It occurs due to LRV squeezing caused by narrowed aortomesenteric angle. SMA syndrome is a disease that the third part of the duodenum is prone to intestinal obstruction by narrowed angle between the SMA and the abdominal aorta. Clinical symptoms include postprandial abdominal distension, epigastric pain, nausea, and vomiting. SMA syndrome and nutcracker syndrome have common features that result from narrowed aortomesenteric angle. However, it is very rare for both syndromes to occur simultaneously, so the two syndromes are regarded as separate diseases. This is a report on a case of nutcracker syndrome with SMA syndrome in a child who presented gross hematuria, recurrent abdominal pain and vomiting. To our knowledge, nutcracker syndrome simultaneous with SMA syndrome has not been previously reported in pediatric patient, especially with an exhibition of gross hematuria. This case suggests that the simultaneous presence of SMA syndrome with the same pathogenesis needs to be considered when nutcracker syndrome is suspected in pediatric patients with hematuria.

Early-stage Diagnosis of Bladder Carcinoma by a Clinical Pharmacist's Effective Anti-coagulation Service in a Patient with Anticoagulation Therapy: a Clinical Case Report (항응고제 투여 환자에서 약사의 효과적인 ACS를 통한 방광암 조기발견 사례)

  • An, Sung-Shim;Bang, Joon-Seok;La, Hyen-Oh
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.1
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    • pp.85-87
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    • 2010
  • Recently, the prevalence of bladder cancer is increasing in the Korean society. As the risk factors of bladder carcinoma are variable, the early-stage diagnosis is regarded the best preventive practice. Hematuria is a specific sign of the malignancy as well as a kind of various medication-related adverse reactions. Some anti-coagulation therapy can cause bleedings including hematuria to the patients with cardiovascular diseases such as paroxysmal atrial fibrillation (PAF). Therefore, to the clinical pharmacists working in the anti-coagulation services (ACS), a closer monitoring of patients can give an opportunity to find certain ailments unexpectedly. In this case, a patient with PAF had episodes of sporadic hematuria in the course of warfarin therapy even though with its low levels of INR. An ACS pharmacist found a discrepancy between the bleeding symptoms and INR values, and recommended properly the patient to refer urologist. Fortunately, an early-stage of bladder carcinoma was found then followed by an excision performed to the lesion. Therefore, alert-minded and precise monitoring done by ACS pharmacist could optimize the therapeutic outcomes as well as increase the quality of life of the patient.