What's Your Diagnosis? Managing Pediatric Patients with Hematuria

Welcome to this month’s What’s Your Diagnosis Challenge!

But before we begin, check to see if you got the previous case on Emergency Department Management of Pediatric Sexual Abuse correct.

Case Presentation: Emergency Department Management of Hematuria in Children

A 10-year-old boy presents to the emergency department with eye swelling and cola-colored urine…

The boy reports a sore throat 2 weeks prior to presentation.
His vital signs are unremarkable, except for a blood pressure of 130/68 mm Hg. On examination, you note periorbital edema. Urinalysis is positive for protein and blood.
What workup is warranted at this time to confirm the diagnosis? What is the patient’s likely disposition?

Case Conclusion

The results of further laboratory studies were significant for an elevated creatinine, negative oropharyngeal rapid strep test, and a positive anti-streptolysin O titer, consistent with post-streptococcal glomerulonephritis. He was admitted to the hospital for diuresis and blood pressure management.