Establishing the diagnosis of benign familial hematuria. The importance of examining the urine sediment of family members
S. S. Blumenthal, C. Fritsche and J. Lemann Jr
Department of Medicine, Medical College of Wisconsin, Milwaukee.
Patients with microscopic hematuria are generally referred for urologic
investigation. We describe 30 patients with normal renal function referred
to our clinic during the years 1970 through 1987 for evaluation of
hematuria, usually microscopic, in whom prior urologic and radiological
studies had failed to determine the cause of bleeding. Urinary sediment
from the patients and first-degree relatives revealed hemoglobin and red
blood cell casts; the inheritance pattern was consistent with autosomal
dominant transmission. During follow-up for up to 18 years, renal function
remained normal, thus confirming the diagnosis of benign familial
hematuria. Immunoglobulin A nephropathy and Alport's syndrome were less
common than benign familial hematuria and could be differentiated from it
by history, physical examination, and routine laboratory testing. Since
benign familial hematuria is a common disorder in adults with hematuria and
normal renal function, urinary sediment from patients and family members
should be examined before extensive urologic and radiological procedures
are performed.
