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December 15, 1978

Unilateral Primary Hematuria

Author Affiliations

From the Division of Nephrology, Department of Medicine, Georgetown University Hospital (Drs Chester, Argy, and Schreiner), and Georgetown University Nephrology Section, DC General Hospital (Dr Diamond), Washington, DC.

JAMA. 1978;240(25):2759. doi:10.1001/jama.1978.03290250063034

PRIMARY hematuria is a term used to describe persistent or recurrent unexplained hematuria, gross or microscopic, that has been demonstrated by biopsy specimen to be of glomerular origin.1 A case of primary hematuria was unusually severe and prolonged, as well as unilateral in origin.

Report of a Case  A 44-year-old man experienced painless hematuria continuously for 16 months. His urine varied in color from that of dark tea to bright red. Packed RBC volume in urine varied between 0.5 and 2 vol%. No clots were noted. The creatinine clearance was 116 ml/min. The proteinuria value ranged between 1.3 and 1.6 g/24 hr, with a urine protein electrophoresis value reflecting a distribution of constituents similar to serum. The patient's packed RBC volume dropped to as low as 26 vol%, with a serum iron level of 44μg/dl and an iron-binding capacity of 333 μg/dl. Cystoscopy demonstrated a bloody efflux from the