Clinical and pathological significance of persistent or recurrent hematuria

의학과/석사[한글] 지속성혈뇨란 현미경적혈뇨가 수개월간 계속되는 상태이며 재발성 혈뇨란 수주, 수개월, 수년의 간격을 두고 육안적혈뇨 및 현미경적혈뇨가 반복되는 상태를 말한다. 그러나 이러한 혈뇨를 보이는 환아는 그 원인질환이 경피적 신생검에 의해 진단 가능한 경우가 많다. 저자는 1978년 7월부터 1981년 6월까지 만 3년간 연세의대 부속 세브란스병원 소아과에 입원하였던 환아로서 3개월이상 지속적인 현미경적혈뇨를 보인 환아 및 수주, 수개월이상의 간격을 두고 현미경적 혹은 육안적혈뇨가 재발되었던 환아로서 경피적 신생검을 실 시하였던 49명을 대상으로 질병의 종류 및 연령별분포, 질병에 따른 혈뇨의 양상 및 검사소견등을 비교 검토하였다. 총 49명의 환아중 남아가 32명, 여아가 17명으로 남녀비는 1.9 : 1이었고 연령별로는 7-10歲의 환아가 28명으로 전체의 57%를 차지하였으며 질병별로는 자반병성신염 환아가 17명으로 가장 많았고 막증식성 사구체신염 환아가 2명으로 가장 적었다. 지속성 혹은 재발성 현미경적혈뇨를 보인 환아는 35명으로서 이중 자반병성신염 ( 16명), Mesangium 증식성 사구체신염(10명), 급성 연구균성 사구체신염(5명)이 주된 환자였다. 재발성 육안적혈뇨 환아는 14명으로서 이중 IgA 신병중(4명), 양성 재발성(4)명 및 가족성혈뇨(3명) 환아가 대부분이었다. Clinical and Pathological Significance of Persistent or Recurrent Hematuria Jong Wie Choi Department of Medical Science The Graduate School Yonsel University (Directed by Prof. Pyung-Kil Klm, H.D.) Recurrent gross hematuria is a condition in which macroscopic hematuria occures repeatedly for several days at interval of a few weeks, months or years. Meanwhile, persistent macroscopic hematuria is a condition in which microscopic hematuria persists for a few months. According to Northway, there areabout 49 diseases in which henaturla is manifested in children. Among a number of renal diseases causing hematuria chil-dhood, mort common cause is acute post-streptococcal glomeru-lonephritis in Korea. There are, however, certain diseases in which the diagnosis is possible only by renal biopsy. Fourty nine cases with renal diseases, were diagnosed by renal biopsy, which were causing persistent or recurrent hematuria. The pathologic findings, clinical and laboratory significance from these patients were analyzed. Male patients were 32 and female were 17, of which ratio was 1.9 : 1. In age distribution, age group between 7 and 10 years was most predominant which was 57% of total patients. The mumber of patients with purpura nephritis were 17, which were most common cause of persistent or recurrent hematuria group Persistent or recurrent microscopic hematuria was demons-trated in 35 cases and predominant in H-SPN (16 cases), MsPGN(1O oases) and APSGW (5 cases). Recurrent gross hematuria was demonstrated in 14 cases and predominant in IgA nephropathy (4 cases), benign recurrent hematuria (4 cases) and benign familial hematuria (3 cases). In MsPGN, only 1 case among 11 children showed recurrent gross hematuria. In purpura nephritis, only 1 case among 15 children in foca proliferative glomerulonephritis showed recurrent gross hematuria. In MPGN, recurrent gross hematuria was also demonstrated in 1 case. [영문] Recurrent gross hematuria is a condition in which macroscopic hematuria occures repeatedly for several days at interval of a few weeks, months or years. Meanwhile, persistent macroscopic hematuria is a condition in which microscopic hematuria persists for a few months. According to Northway, there areabout 49 diseases in which henaturla is manifested in children. Among a number of renal diseases causing hematuria chil-dhood, mort common cause is acute post-streptococcal glomeru-lonephritis in Korea. There are, however, certain diseases in which the diagnosis is possible only by renal biopsy. Fourty nine cases with renal diseases, were diagnosed by renal biopsy, which were causing persistent or recurrent hematuria. The pathologic findings, clinical and laboratory significance from these patients were analyzed. Male patients were 32 and female were 17, of which ratio was 1.9 : 1. In age distribution, age group between 7 and 10 years was most predominant which was 57% of total patients. The mumber of patients with purpura nephritis were 17, which were most common cause of persistent or recurrent hematuria group Persistent or recurrent microscopic hematuria was demons-trated in 35 cases and predominant in H-SPN (16 cases), MsPGN(1O oases) and APSGW (5 cases). Recurrent gross hematuria was demonstrated in 14 cases and predominant in IgA nephropathy (4 cases), benign recurrent hematuria (4 cases) and benign familial hematuria (3 cases). In MsPGN, only 1 case among 11 children showed recurrent gross hematuria. In purpura nephritis, only 1 case among 15 children in foca proliferative glomerulonephritis showed recurrent gross hematuria. In MPGN, recurrent gross hematuria was also demonstrated in 1 case.restrictio