Fatma Nur Sarı, Mehmet Bülbül, Gülay Demircan, Özlem Erdoğan, Sinan Sarı, Leyla Memiş, Ayşe Öner

Çocukluk çağında hematürinin etiolojik nedenleri Özgün Araştırma

Özet Amaç: Çalışmamızda hematürinin nedenleri seyirdeki önemi ve ayırıcı tanının gerekliliği gösterilerek gereksiz girişimsel incelemelerin önlenmesi amaçlanmıştır Gereç ve Yöntem: Ocak 1999 ile Haziran 2004 tarihleri arasında hastanemiz Nefroloji Polikliniği rsquo;nde hematüri nedeni ile izleme alınan 4 ay ile 16 yaş arasındaki 300 hasta 146 rsquo;sı 48 7 kız 154 rsquo;ü 51 3 erkek ortalama yaşları 90 plusmn;40 4 192 ay geriye dönük olarak değerlendirildi Hastalar makroskobik hematüri asemptomatik izole mikroskobik hematüri mikroskobik hematüri ve klinik bulgular asemptomatik mikroskobik hematüri ve proteinüri olarak dört grupta incelendi Bulgular: Olguların 136 rsquo;sında 45 3 makroskobik hematüri 164 rsquo;ünde 54 7 mikroskobik hematüri vardı Olguların 34 3 rsquo;ünde glomerüler nedenler 27 4 rsquo;ünde taş ve kristalüri 12 rsquo;sinde enfeksiyonlar 10 rsquo;unda anatomik bozukluklar saptandı İzole mikroskobik hematüride en sık neden olarak kristalüri saptanırken diğer gruplarda hematüri nedeni olarak en sık glomerüler hastalıklar saptandı Tanı amaçlı 33 hastaya böbrek biyopsisi yapıldı Bir hasta dışında tüm biyopsi örneklerinde glomerülopati saptandı Biyopsi yapılan hastaların ortalama hematüri süresi 614 plusmn;681 gün iken yapılmayanların 135 plusmn;384 gün olarak izlendi Çıkarımlar: Çocukluk yaş grubunda makroskobik ve mikroskobik hematüri ile başvuran hastalarda en sık olarak glomerüler hastalıklar saptanmıştır Glomerüler hastalıkları taş hastalığı kristalüri ve enfeksiyonlar izlemektedir Tanıda uzun süreli izlemde seçilmiş olgularda böbrek biyopsisi düşünülmelidir Türk Ped Arş 2010; 45: 246 51 Anahtar sözcükler: Çocuk etiolojik nedenler hematüri

Anahtar Kelimeler:

Çocuk, etiolojik nedenler, hematüri

Etiology of hematuria in childhood Original Article

Summary Aim: The aim was evaluating the causes of hematuria showing the consequence of the prognosis and differential diagnosis and preventing unnecessary invasive tests Material and Method: A retrospective study was conducted in patients aged between 4 months and 16 years who referred to the nbsp; nephrology clinic with the complaint of hematuria between January 1999 and June 2004 The patients were grouped as fallows: macroscopic hematuria asymptomatic isolated microscopic hematuria microscopic hematuria with clinical findings and asymptomatic microscopic hematuria with proteinuria Results: Macroscopic and microscopic hematuria were detected in 136 and 164 patients respectively The cases were diagnosed as glomerular diseases 34 3 urinary stone disease and crystalluria 27 4 infections 12 and anatomic abnormalities 10 The most common cause of hematuria was crystalluria in isolated microscopic hematuria group and glomeruler diseases in the other groups Renal biopsy was performed to 33 patients Glomerulopathy was detected in 32 cases The duration of hematuria was 614 plusmn;681 and 135 plusmn;384 days in biopsy performed group or not respectively Conclusions: Glomerular diseases were stated as the most common causes of hematuria in childhood Urinary stone disease crystalluria and infections were other causes of hematuria in our study group In long term follow up renal biopsy should be considered in selected cases Turk Arch Ped 2010; 45: 246 51 Key words: Children etiology hematuria

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