Hypercalciuria as a Cause of Genital Bleeding in a 6-Year-Old Girl

Abstract 

Study Objective

To document an unusual cause of genital bleeding in a 6-year-old girl.

Design

Case report.

Setting

Outpatient pediatric gynecology clinic in a tertiary care hospital.

Results

Clinical presentation of a case of genital bleeding secondary to hypercalciuria in a 6-year-old female. Gynecologic investigations were negative. There were hematuria on urinalysis and an elevated calcium-to-creatinine ratio on initial presentation; however, no evidence of urolithiasis was found on ultrasound. In the context of negative investigations and persistent episodes of bleeding, the hypercalciuria was treated with hydrochlorothiazide. Normalization of calciuria was associated with the end of genital bleeding episodes.

Conclusion

Hypercalciuria with microcrystals and urethral irritation should be considered as part of the differential diagnosis for genital bleeding in girls.

Key Words: Child, Female, Menarche, Uterine hemorrhage, Precocious puberty, Hematuria, Calcium