H

hematuria BLOODin the URINE. Hematuria may
result from numerous circumstances and always
requires medical evaluation to determine the
underlying cause. Though BLADDER CANCER is
uncommon, hematuria often is the earliest sign of
its presence. Gross hematuria occurs when the
amount of blood in the urine is sufficient to dis-
color the urine (typically pink, red, or brown).
Occult, or microscopic, hematuria occurs when
the amount of blood in the urine is very slight,
detected during microscopic examination of the
urine.
Urinalysis is the first step of the diagnostic path,
with additional diagnostic procedures, depending
on the findings and the symptoms. Treatment tar-
gets the underlying cause. Certain medications or
foods may cause the urine to be pink or red, in
which case the urinalysis shows there to be few
erythrocytes (red blood cells) present in the urine.
MENSTRUATION may also give the appearance of
blood in the urine.

CONDITIONS FOR WHICH

HEMATURIA IS A COMMON SYMPTOM

BENIGN PROSTATIC HYPERPLASIA(BPH) BLADDER CANCER
BLUNT TRAUMAto the abdomen or back CHLAMYDIA
CYSTITIS EPIDIDYMITIS
GENITAL TRAUMA GONORRHEA
PROSTATITIS pyelonephritis
TRICHOMONIASIS URETHRITIS
URINARY TRACT INFECTION(UTI) UROLITHIASIS

See also ANURIA; DYSURIA; ENURESIS; NOCTURIA;
OLIGURIA.

hemolytic uremic syndrome RENAL FAILUREthat
occurs as a rare complication in children after
INFECTION with Escherichia coli O157:H7 acquired

from contaminated food. E. coliO157:H7 causes

hemorrhagic ENTERITIS, itself a life-threatening

infection. Hemolytic uremic syndrome occurs

when the toxins the E. coliO157:H7 release enter

the bloodstream. The toxins destroy erythrocytes

(red BLOOD cells) and platelets (clotting cells).

Remnants of the destroyed blood cells clog the

glomeruli within the KIDNEYS, preventing blood

from flowing through these filtering structures. As

more glomeruli become affected, the kidneys can

no longer filter toxins from the blood.

Symptoms and Diagnostic Path

The symptoms of hemolytic uremic syndrome

begin to emerge as the child appears to be recov-

ering from the enteritis. The earliest indication of

hemolytic uremic syndrome is the appearance of

PETECCHIAE, pinpoint hemorrhages under the sur-

face of the SKIN, in a child recovering from E. coli

O157:H7 hemorrhagic enteritis. Other symptoms

include reduced URINEvolume, fatigue, irritability,

and pale skin. Blood tests typically show the dam-

aged blood cells and indications of diminishing

kidney function. However, the child becomes life-

threateningly ill very rapidly, requiring immediate

hospitalization and intensive medical treatment.

Treatment Options and Outlook

There is no cure for hemolytic uremic syndrome.

Treatment consists of intensive supportive care

while the condition runs its course, including

efforts to maintain the child’s fluid and electrolyte

balances as well as RENAL DIALYSISto filter toxins

from the blood. The renal failure disrupts all body

systems and functions, often causing severe HYPER-

TENSION(high BLOOD PRESSURE), other cardiovascu-

lar problems, LIVERdysfunction, and neurologic

dysfunction. With prompt and aggressive medical

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