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Recurrent haematuria in a toddler: a journey from suspected UTI to precocious puberty

Numerous factors can contribute to the presence of blood in the urine. While the causes of gross haematuria often suggest a urological origin, it may also result from gynaecological pathology contaminating the urine. We present a case of a 2-year-2-month-old girl who presented with recurrent haematu...

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Main Authors: Azmi, Nurul Husna, Abd Razak, Najihah, Che' Man, Mohamad
Format: Article
Language:English
Published: UniKL Royal College of Medicine Perak (UniKL RCMP) Managed by P.C.M. SDN. BHD 2024
Subjects:
R Medicine (General)
RA Public aspects of medicine
Online Access:http://irep.iium.edu.my/118505/7/118505_Recurrent%20haematuria%20in%20a%20toddler.pdf
http://irep.iium.edu.my/118505/
https://www.ajmhsrcmp.org/
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spelling my.iium.irep.1185052025-01-10T06:21:46Z http://irep.iium.edu.my/118505/ Recurrent haematuria in a toddler: a journey from suspected UTI to precocious puberty Azmi, Nurul Husna Abd Razak, Najihah Che' Man, Mohamad R Medicine (General) RA Public aspects of medicine Numerous factors can contribute to the presence of blood in the urine. While the causes of gross haematuria often suggest a urological origin, it may also result from gynaecological pathology contaminating the urine. We present a case of a 2-year-2-month-old girl who presented with recurrent haematuria, her third episode in five months. Her previous two episodes were treated as urinary tract infections (UTI). One week before this most recent presentation, she had an upper respiratory tract infection, which resolved with a course of antibiotics. Although she was normotensive, she was referred to a tertiary centre for suspected post-streptococcal glomerulonephritis, based on urinalysis findings of erythrocytes 3+, trace proteinuria and presence of leukocytes. At the hospital, she was initially treated with antibiotics for probable UTI. However, persistent fresh blood staining her diaper prompted a second genital evaluation, which revealed blood seeping from the vagina. Further assessment showed signs of puberty suggesting that menstruation was contaminating the urine sample. This case report highlights the need for clinicians to consider a broad differential diagnosis when evaluating haematuria in paediatric patients and the importance of thoroughly assessing secondary sexual characteristics in young girls with haematuria to facilitate early recognition of precocious puberty. UniKL Royal College of Medicine Perak (UniKL RCMP) Managed by P.C.M. SDN. BHD 2024-11-01 Article PeerReviewed application/pdf en http://irep.iium.edu.my/118505/7/118505_Recurrent%20haematuria%20in%20a%20toddler.pdf Azmi, Nurul Husna and Abd Razak, Najihah and Che' Man, Mohamad (2024) Recurrent haematuria in a toddler: a journey from suspected UTI to precocious puberty. Asian Journal of Medicine and Health Sciences, 7 (2). pp. 308-315. E-ISSN 2637-0603 https://www.ajmhsrcmp.org/
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
topic R Medicine (General)
RA Public aspects of medicine
spellingShingle R Medicine (General)
RA Public aspects of medicine
Azmi, Nurul Husna
Abd Razak, Najihah
Che' Man, Mohamad
Recurrent haematuria in a toddler: a journey from suspected UTI to precocious puberty
description Numerous factors can contribute to the presence of blood in the urine. While the causes of gross haematuria often suggest a urological origin, it may also result from gynaecological pathology contaminating the urine. We present a case of a 2-year-2-month-old girl who presented with recurrent haematuria, her third episode in five months. Her previous two episodes were treated as urinary tract infections (UTI). One week before this most recent presentation, she had an upper respiratory tract infection, which resolved with a course of antibiotics. Although she was normotensive, she was referred to a tertiary centre for suspected post-streptococcal glomerulonephritis, based on urinalysis findings of erythrocytes 3+, trace proteinuria and presence of leukocytes. At the hospital, she was initially treated with antibiotics for probable UTI. However, persistent fresh blood staining her diaper prompted a second genital evaluation, which revealed blood seeping from the vagina. Further assessment showed signs of puberty suggesting that menstruation was contaminating the urine sample. This case report highlights the need for clinicians to consider a broad differential diagnosis when evaluating haematuria in paediatric patients and the importance of thoroughly assessing secondary sexual characteristics in young girls with haematuria to facilitate early recognition of precocious puberty.
format Article
author Azmi, Nurul Husna
Abd Razak, Najihah
Che' Man, Mohamad
author_facet Azmi, Nurul Husna
Abd Razak, Najihah
Che' Man, Mohamad
author_sort Azmi, Nurul Husna
title Recurrent haematuria in a toddler: a journey from suspected UTI to precocious puberty
title_short Recurrent haematuria in a toddler: a journey from suspected UTI to precocious puberty
title_full Recurrent haematuria in a toddler: a journey from suspected UTI to precocious puberty
title_fullStr Recurrent haematuria in a toddler: a journey from suspected UTI to precocious puberty
title_full_unstemmed Recurrent haematuria in a toddler: a journey from suspected UTI to precocious puberty
title_sort recurrent haematuria in a toddler: a journey from suspected uti to precocious puberty
publisher UniKL Royal College of Medicine Perak (UniKL RCMP) Managed by P.C.M. SDN. BHD
publishDate 2024
url http://irep.iium.edu.my/118505/7/118505_Recurrent%20haematuria%20in%20a%20toddler.pdf
http://irep.iium.edu.my/118505/
https://www.ajmhsrcmp.org/
_version_ 1821105184427737088
score 13.244413

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