Asymptomatic haematuria

Question 1

What can cause asymptomatic haematuria?

Answer 1

IgA nephropathy
Thin glomerular basement membrane disease
Alport’s syndrome

Question 2

What is IgA nephropathy?

Answer 2

Glomerulonephritis due to immune system targeting the glomerulus post URTI causing damage and IgA to be deposited in the tissue
Can progress to nephritic syndrome

Question 3

How does IgA nephropathy commonly present?

Answer 3

Young male with episodic microscopic haematuria a few days after URTI
Rapid recovery between attacks

Question 4

What investigations can be done in a patient with suspected IgA nephropathy?

Answer 4

Urine dip - Microscopic haematuria

Biopsy - IgA deposited in mesangium

Question 5

What is the treatment for IgA nephropathy?

Answer 5

Steroids

Cyclophosphamide if renal function declining

Question 6

What is thin basement membrane disease?

Answer 6

An autosomal dominant disorder that causes thinning of the basement membrane in the glomeruli possibly due to a collagen IV defect. Patients maintain a good renal function throughout

Question 7

What are the features of thin basement membrane disease?

Answer 7

Persistent asymptomatic microscopic haematuria is found on urinalysis
HTN and proteinuria is seen in a small number of patients

Question 8

What is Alport’s syndrome?

Answer 8

X linked inheritance 
Glomerulonephritis
Hearing loss
Renal failure
Can also cause eye problems such as cataracts and retinal flecks

Question 9

What are the features of Alport’s syndrome?

Answer 9

Haematuria
Proteinuria
Sensorineural deafness
Lens dislocation + cataracts
Retinal flecks
*Females may have haematuria only*