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Persistent Hematuria in 4-Year-Old Girl: Possible Focal Glomerulonephritis

This case study presents a 4-year-old girl with persistent microscopic hematuria. Despite investigations revealing no conclusive information, a probable diagnosis of focal glomerulonephritis is suggested. Further tests, including needle biopsy and open renal biopsy, indicate features consistent with Alport's syndrome or hereditary nephritis.

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Persistent Hematuria in 4-Year-Old Girl: Possible Focal Glomerulonephritis

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  1. U78-5672ID:434500-5 A 4-year-old girl had persistent hematuria (microscopic) found by routine urinalysis. Patient has been symptom free. Been investigated with no good information revealed. Probable diagnosis Focal glomerulonephritis.

  2. IF • IgG –Negative. • IgA –Negative. • IgM –Negative. • C3 –Negative. • Fibrinogen –Negative.

  3. Interpretation • The minimal findings are compatible with “idiopathic (essential) hematuria” or with “benign familial hematuria”. • Persistent “fetal type glomeruli” are a feature of early cases of “Alport’s syndrome”, these can be seen in infantile kidneys with persistent fetal lobulation of the cortex. • The absence of focal proliferative changes in glomeruli mitigates against a diagnosis of focal glomerulonephritis.

  4. DIAGNOSIS • Needle biopsy of kidney showing a few persistent “fetal Glomeruli” renal glomeruli and occasional red cell casts within renal tubules.

  5. EM82-5343 Glomerulonephritis (open renal biopsy).

  6. IF • IgG – Negative. • IgA – Negative. • IgM – Negative. • C3 – Negative. • Properdin – Negative.

  7. DIAGNOSIS • Probable “Progressive Hereditary Nephritis” (Alport’s syndrome).

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