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Hematuria in a 5-Year-Old Boy: Common Causes and When to See a Doctor

Blood in the urine (hematuria) in a young child always warrants medical evaluation. Common causes include:

Infectious/Inflammatory

  • Urinary tract infection (UTI): dysuria, frequency, abdominal pain.
  • Post-streptococcal glomerulonephritis: hematuria, edema, hypertension 1–3 weeks after strep throat.

Structural/Mechanical

  • Kidney/ureteral stones: colicky flank pain, microscopic or gross hematuria.
  • Ureteropelvic junction (UPJ) obstruction, vesicoureteral reflux.
  • Trauma (sports, falls).

Hematologic

  • Von Willebrand disease, hemophilia, thrombocytopenia.

Neoplastic (Rare)

  • Wilms tumor (nephroblastoma), renal cell carcinoma.

Diagnostic Approach

  1. Urinalysis with microscopy (RBC morphology, casts, protein).
  2. Urine culture.
  3. Renal ultrasound.
  4. CBC, coagulation studies, renal function, ASO titer if indicated.
  5. Referral to pediatric nephrology/urology as needed.

Do not delay evaluation—early diagnosis improves outcomes, especially for glomerular disease and malignancy.

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