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Persistent Hematuria in a 4 - 5 year old
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Persistent Hematuria in a 4 - 5 year old

My now 5 year old daughter has had repeated labs with blood +1 and +2.  The most recent was +2 and Positive for Ketones.  Can someone look at this and tell me if I am doing enough?  I have taken her to a pediatric nephrologist who said just to follow up every year.  We have had the tests below and normal ultrasound imaging.  She has occasional, sporadic frequency and urgency.  Never any protein. As an infant, she was diagnosed with vesicoureteral reflux, but after a year, her imaging showed no signs of it.  Her maternal grandmother has autoimmune hepatitis.  Mother has Fibromyalgia.  No family history of bleeding or renal issues.  Thanks for taking the time to talk to a worried mom.

URINALYSIS COMPLETE - 08/28/12
Results:
- U GLU: NEGATIVE  
- U BILI: NEGATIVE  
- U KET: NEGATIVE  
- U SG: >=1.030  
- U BLD: 1+  
- U PH: 6.0  
- U PRO: NEGATIVE  
- U URO: 0.2  
- U NIT: NEGATIVE  
- U LEUK: NEGATIVE  
- U WBC: 6-10  
- U RBC: occ  
- U EPI CELLS: Present  
- U BAC: Trace  
URINALYSIS COMPLETE - 10/11/12
Results:
- U GLU: NEGATIVE  
- U BILI: NEGATIVE  
- U KET: NEGATIVE  
- U SG: 1.025  
- U BLD: 2+  
- U PH: 6.0  
- U PRO: NEGATIVE  
- U URO: 0.2  
- U NIT: NEGATIVE  
- U LEUK: NEGATIVE  
- U WBC: 0-3  
- U RBC: 1-4  
- U EPI CELLS: Present  
- U BAC: Trace  
- MUC: Present  
• URINALYSIS COMPLETE - 10/09/12
Results:
- U GLU: NEGATIVE  
- U BILI: NEGATIVE  
- U KET: NEGATIVE  
- U SG: >=1.030  
- U BLD: 2+  
- U PH: 6.0  
- U PRO: NEGATIVE  
- U URO: 0.2  
- U NIT: NEGATIVE  
- U LEUK: NEGATIVE  
- U WBC: 1-4  
- U RBC: 6-12  
- U EPI CELLS: Present
- U BAC: Trace  
- MUC: Present


1. MICROSCOPIC HEMATURIA (599.72)
• URINALYSIS COMPLETE W/ CULTURE
• CALCIUM, RANDOM URINE (W/ CREATININE)
• CBC W/DIFF
• ULTRASOUND, KIDNEY
• BASIC METABOLIC PANEL
• ASO TITER
• C3 COMPLEMENT
• ANA W/REFLEX IF POSITIVE
Imaging/Diagnostic Result - 10/12/12
Notes - ultrasound kidney
•  C3 COMPLEMENT - 10/11/12
Result:
- COMPLEMENT C3, SERUM: 122  
•  GRAM NEGATIVE SENSITIVITY - 10/11/12
Results:
- SXT: R  
- CEPHALOTHIN: I  
- NITROFURANTOIN: S  
- GENTAMICIN: S  
- CIPRO: R  
- NORFLOXACIN: R  
- AMOXICILLIN: S  
- CARBENICILLIN: R  
- OFLOXACIN: R  
- AMPICILLIN: R  
- CEFAZOLIN: S  
- CEFTRIAXONE: S  
• ORGANISM IDENTIFICATION - 10/11/12
Result:
- ORG ID: Cit amalonaticus  
• CULTURE, URINE - 10/11/12
Results:
- 24 HR REPORT: 41,000-50,000GNO  
- OXIDASE: NEGATIVE  
- ORG ID: Cit amalonaticus  
• ASO - 10/11/12
Result:
- ANTISTREPTOLYSIN O AB: 7.0  
• ANA W/REFLEX IF POSITIVE - 10/11/12
Result:
- ANA DIRECT: NEGATIVE  
• CALCIUM/CREATININE RATIO - 10/11/12
Results:
- CALCIUM, URINE: 22.6  
- CREATININE, URINE: 126.9  
- CALCIUM/CREAT.RATIO: 178  
• CULTURE, THROAT - 10/11/12
Result:
- ORG ID: Normal Flora  
• CBC - 10/11/12
Results:
- WBC: 4.46   Low
- RBC: 4.38  
- HGB: 13.0  
- HCT: 37.7  
- MCV: 86.0  
- MCH: 29.6  
- PLT: 266.00  
- MCHC: 34.5  
- MPV: 6.56   Low
- RDW: 11.5  
- NEU: 46.80  
- LYMPH: 25.80  
- EOS: 3.31  
- BASO: 1.86  
- MONO: 22.20   High
• BASIC METABOLIC PANEL - 10/11/12
Results:
- BUN: 14  
- CREA: 0.3   Low
- NA: 136.0  
- K: 4.10  
- CL: 104.0  
- CA: 9.6  
- CO2: 23.4  
- GLU: 89  

This week:
- U BLD: 2+, Ketones: Positive
Vitals
Blood Pressure: 100/68  
Height:  3 ft 11 in (93rd %)  Weight:  66 lbs 4 oz (99th %)  BMI:  21.1 (99th %)
Otherwise very healthy
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selmaS
Allentown, PA