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LPHS is considered a diagnosis of exclusion. The syndrome presents with hematuria (blood in the urine) and flank (a region of the lower back beneath the ribs and above the ilium) pain which can result from a number of causes. Nonglomerular causes of bleeding (e.g., urinary infection, tumor, or nephrolithiasis) must be excluded.
Hematuria can be classified according to visibility, anatomical origin, and timing of blood during urination. [1] [6]In terms of visibility, hematuria can be visible to the naked eye (termed "gross hematuria") and may appear red or brown (sometimes referred to as tea-colored), or it can be microscopic (i.e. not visible but detected with a microscope or laboratory test).
The diagnosis is often made based on the medical history, blood samples, and a urine sample. The absence of urine RBCs and RBC casts microscopically despite a positive dipstick test suggests hemoglobinuria or myoglobinuria. The medical term for RBCs in the urine is hematuria.
Blood culture - This is the process where a sample of the patient's blood is sent to the microbiology lab to attempt to isolate and grow any bacteria that may be circulating in the blood, in order to identify the pathogen. [34] This is helpful if the physician suspects infection as the underlying cause of the nephritic syndrome. [citation needed]
Blood tests (to monitor levels of platelets, red blood cells, and white blood cells), stool tests (especially to check for microscopic or macroscopic levels of fresh or old blood), urinalysis (to help monitor kidney function, like blood urea nitrogen, or BUN, levels, pH, and for blood in the urine- hematuria) [3] Differential diagnosis
Hemosiderinuria (syn. haemosiderinuria) is the presence of hemosiderin in urine. [1] It is often the result of chronic intravascular hemolysis, in which hemoglobin is released from red blood cells into the bloodstream in excess of the binding capacity of haptoglobin. The function of haptoglobin is to bind to circulating hemoglobin, thereby ...
In straightforward cases, a diagnosis may be made and treatment given based on symptoms alone without further laboratory confirmation. [4] In complicated or questionable cases, it may be useful to confirm the diagnosis via urinalysis, looking for the presence of urinary nitrites, white blood cells (leukocytes), or leukocyte esterase. [54]
Diagnosis is made by history and examination. [citation needed] In immunocompromised patients, pus is present in the urine but often no organism can be cultured. In children, polymerase chain reaction sequencing of urine can detect fragments of the infectious agent. [citation needed] The procedure differs somewhat for women and men.