Microscopic Hematuria

CLINICAL DIAGNOSTIC MANUAL

Microscopic hematuria is defined as the presence of blood in the urine that is not visible to the naked eye but can be detected through microscopic analysis of urinary sediment.

This condition can be a sign of various pathologies affecting the urinary tract and kidneys. Identifying the underlying cause of microscopic hematuria is essential to provide appropriate treatment and prevent potential complications.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Menstruation	Presence of menstrual blood in urine, regular menstrual cycle	Medical history, physical examination, menstrual cycle	Repeat urine analysis outside of the menstrual period
Urinary infection	Dysuria, urinary urgency, suprapubic pain, fever	Medical history, physical examination, signs of infection	Urine culture, urinalysis
Urethral trauma	Urethral pain, history of trauma, post-trauma hematuria	Trauma history, physical examination	Cystoscopy, ultrasound
Hemorrhagic diathesis	Prolonged bleeding, easy bruising, history of bleeding episodes	Medical history, physical examination, signs of generalized bleeding	Coagulation tests (PT, aPTT, INR), complete blood count
Kidney stone	Severe colicky pain, hematuria, nausea, vomiting	Medical history, physical examination, signs of renal pain	Ultrasound, abdominal CT scan
Glomerulonephritis	Hematuria, proteinuria, edema, hypertension	Medical history, physical examination, signs of renal insufficiency	Urinalysis, kidney biopsy
Secondary nephritis	Hematuria, proteinuria, edema, hypertension, history of systemic disease	Medical history, physical examination, signs of systemic disease	Urinalysis, kidney biopsy, specific studies for underlying disease
Renal tumour	Hematuria, palpable abdominal mass, weight loss, flank pain	Medical history, physical examination, signs of abdominal mass	Ultrasound, abdominal CT scan, biopsy if necessary