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Adolescent with intermittent haematuria
  1. Roberto Pillon1,
  2. Marco Pennesi2,
  3. Ingrid Rabach2,
  4. Egidio Barbi1,2
  1. 1Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy
  2. 2Paediatrics, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
  1. Correspondence to Dr Roberto Pillon, Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste 34127, Italy; ropillon{at}gmail.com

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A previously healthy 16-year-old boy was referred for a 3-day history of gross haematuria without pain or other symptoms. Family history was negative for renal disease or hearing loss. Physical examination showed a tall and slim boy, blood pressure was 112/68 mm Hg, heart rate was 58/min, there was no oedema and the body weight was referred as stable.

Remarkably, during the observation period, the boy passed alternately dark reddish and light pink urine; urinary output was normal (1.2 mL/kg/hour).

Urine dipstick showed haematuria (4+) with proteinuria (2+). Repeated microscope urine analysis showed erythrocytes with both glomerular and postglomerular appearance, without casts.

Laboratory tests, including creatinine, C3, C4, electrolyte, serum albumin, immune-globulins, cholesterol and triglycerids, were normal, while autoantibodies (anti-neutrophil cytoplasmic antibodies, antinuclear antibodies and anti-DNA) and antistreptolysin O were negative. Proteinuria in 24-hour urine collection was quantified as 4 g (normal values <150 mg/24 hours). Renal ultrasonography showed normal kidneys and bladder, without stones. A CT scan of his abdomen was performed (figures 1 and 2).

Figure 1

CT angiography showed a narrowing of the left …

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