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Asymptomatic Hematuria in Women

Arch Intern Med. 1990;150(4):911. doi:10.1001/archinte.1990.00390160151035.
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To the Editor.—In Bard's1 recent review of the economic implications of urologic investigation of asymptomatic hematuria in women, he points out the low yield of urologic investigation. Unfortunately, I feel he has done a great disservice to patients with hematuria by suggesting that this problem is usually one of a urologic nature, and ignores the many other causes of hematuria, particularly those that are glomerular in origin.2 The glomerular origin of hematuria is suggested from the urinalysis by the presence of proteinuria, red blood cell casts, or dysmorphic red blood cells. This study makes no mention of renal function, the degree of proteinuria, if any, and dismisses the ability to differentiate glomerular bleeding from other causes by phasecontrast microscopy of red blood cell morphology. Fairley and Birch3 clearly described their technique for identifying glomerular bleeding in 1982, a practice commonly employed by nephrologists.

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