Hematuria in a 7-year-old Internationally Adopted Male: Case
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A 7 year old male, recently adopted from Ethiopia, presented to the pediatrician with hematuria. Parents noted hematuria for about 2–3 weeks, observing gross blood at either the beginning or the end of the urinary stream. Over the past few days, the coloring had been getting lighter (only faint pink). He seemed to urinate frequently but did not show signs of constipation.

Urinalysis showed 6 RBCs and 108 WBCs per high powered field and negative protein, leukocyte esterase and nitrites. A repeat renal and bladder US done 1 week later confirmed multiple bladder masses similar to the prior examination without hydronephrosis. Given the persistence of the mass-like lesions, cystoscopy and biopsy of lesions were performed to rule out malignancy. The patient’s urine on examination of ova and parasites was positive for Schistosoma haematobium.

The treatment for schistosomiasis includes 2 doses of praziquantel at 40?mg/kg BD for 1 day. Within 2 months after praziquantel treatment, patient’s US showed improvement in bladder wall thickening and masses and he no longer had symptomatic hematuria. Four months after treatment, a peripheral eosinophilia (37%) was noted, which was thought to be due to significant parasite death. Nine months after therapy, urine ova and parasites remained negative, and the patient remained asymptomatic. Peripheral eosinophilia declined slowly over the next few months. He is currently followed yearly by urology with repeat renal and bladder ultrasounds to monitor the bladder masses. At most recent evaluation 3 years after treatment, there remained 2 lobulated masses within the bladder that were shrinking in size.

source: https://journals.lww.com/pidj/Fulltext/2020/10000/Hematuria_in_a_7_year_old_Internationally_Adopted.31.aspx
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