Question

On a cold February day, a 6-year-old boy was brought to the emergency room by his frantic mother because he had passed red urine and looked very pale. He was a normal, active boy, and in fact has played out in the snow the day before. He had the "flue" for about 1 week about 10 days before this episode. He had not received any medication except acetaminophen. On admission, his CBC values were: WBC 12.0 x 10^9L, RBC 3 x 10^12L, Hb 8g/dL, Hct 22%, platelets 350 x 10^9L. the differential cell count was 40% neutrophils, 10% bands, 43% lymphocytes, and 7% monocytes. the reticulocytes count was .9%.

1. do the hemoglobin and hematocrit values match?

2. what is the most likely cause of the red urine?

3. what are the possible diagnoses?

4. what additional tests could help determine the diagnosis?

5. what treatment is indicated?

Answer 1

1. Both the hemoglobin and hematocrit value does not match and they are decreased than the normal value because of hematuria .

2. The most likely cause of red urine is urinary tract infection based on the signs and symptoms mentioned above

3. The possible diagnosis are :-

- Urinary tract infection

- Kidney stones

- Cancerous and non cancerous tumor

- Benign prostate hyperplasia

4. The additional test that would help the diagnosis are :-

- Ultrasound of KUB

- CT scan

- LFT /RFT

- PT/ INR

- X- Ray of abdomen and pelvis

- Tumor markers