[Significance and prognosis of idiopathic macrohematuria in childhood. Long-term surveillance of 45 patients].

Idiopathic macrohematuria represents 14 to 15% of all macroscopic hematurias in children, being more frequent than in adults (5 to 8%). Of 45 children admitted with this affection between 1968 and 1982, 45 were followed up regularly over 2 to 16 years (mean 9 years). Initial investigations included urine cytobacteriology, blood tests, urography and mictional cysto-urethrography, cystoscopy, immunology and renal ultrasound imaging (since 1978). Review examinations were comprised of blood and urine biologic tests, a standard abdominal radiograph, renal and bladder ultrasound imaging and urography (in 19 cases with persistent macro- or micro-hematuria). Of these 45 cases, macrohematuria was no longer present after 1 year in 31 cases (69%), and persisted for a maximum of 8 years until finally disappearing in 10 cases (22%): it persisted without change in 4 cases (8.8%). During follow up surveillance, 37 children (82.2%) failed to present any urinary affection, but 8 children (17.8%) were found to have urologic or nephrologic disease possibly responsible for the hematurial (including 5 cases of lithiasis). Analysis of findings showed associated urinary affections in 6% of cases when hematuria ceased before the 1st year and in 36% when it persisted. At the present time all 45 children have normal renal function, and idiopathic macrohematuria in children can be considered to be a benign lesion when the diagnosis is confirmed by very complete investigations.