Clinical Cases

An Approach to a Case of Haematuria

Drs. Ashim Klumar Das and Abhijit Dutta present a case of Hematuria in 72 year old man.

ABSTRACT:

Haematuria is a clinical condition where there is presence of frank blood or RBCs in the urine. It’s a symptom rather an isolated disease entity, but a symptom of various benign or grave underlying disease conditions. The rationale of this case report is to demonstrate the improvement by homoeopathic treatment when focused on the more general side of the anamnesis.

INTRODUCTION:

Haematuria is a clinical condition where there is presence of frank blood or RBCs in the urine. It’s a symptom rather an isolated disease entity. It may be  idiopathic and /or benign, or it can be a sign that there is a kidney stone or a tumor in the urinary tract (kidneysuretersurinary bladderprostate, and urethra), ranging from trivial to lethal. If white blood cells are found in addition to red blood cells, then it is a signal of urinary tract infection. There are also painful or painless haematurias.

More common causes include:

The most common causes of hematuria are:

Diagnostics includes urinalysis, CT scanning, Ultra sound, Cystoscopy etc. Diagnostic tools should be used according to the relevancy of clinical findings and correlated accordingly.

CASE REPORT

Mr. XYZ, age 72yrs, a male patient of Haldarpara, Baltiguri, Howrah presented in surgery OPD of M.B.H.M.C &H with bright red, large clots during micturation,   occurring for 6 days while bending forward, along with swelling of the right hypochondrium.

He has a past history of prostatectomy and neck femur fracture.  No relevant family history was found.  His domestic environment is damp. He has an addiction to tobacco smoking. He has a history of having completed vaccinations.

Generalities:

    Physical: 

  • Appearance: Pale face, sunken cheeks, emaciated, dry and parched lips.
  • Thermal relation: chilly patient, hot palms
  • General tendency: easily catches cold
  • Appetite: good, can’t tolerate hunger, burning sensation in hypogastrium
  • Desire: Meat, Sour
  • Aversion: Milk
  • Thirst: less, 1.5-2 lit/day, small quantity at long interval
  • Sweat: Profuse over the chest and back
  • Stool: Constipated, twice daily, Mucous present, has to give much strain to defecate.
  • Urine: clear, but offensive
  • Sleep: Disturbed, 4-6hrs
  • Dream: of past events, of dead people
  • Tongue: Flabby, moist, dirty coating on tongue, imprint of teeth, and multiple cracks are present

Mind:

  • Indifferent, desire to be alone, easily angered, avoids society, zealous, memory is poor. The patient is passing large clots in urine. He is very cheerful and not debilitated.

CHARACTERISTICS:

  1. Indifferent, desire to be alone, easily angered, avoids the society,zealous
  1. Memory is poor, though the patient is passing large clots in urine but
  2. He is very cheerful and not debilitated.
  3. Pale face, sunken cheeks, and emaciated, dry and parched lips.
  4. Chilly patient, hot palm
  5. Good, can’t tolerate hunger, burning sensation in hypogastrium
  6. Thirst: less, 1.5-2 lit/day, small quantity at long interval
  7. Stool: Constipated, twice daily, Mucous present, has to give much  strain to defecate
  1. Dream: of past events, of dead people
  2. Tongue: Flabby, moist, dirty coating on tongue, imprint of teeth, and  multiple cracks are present
  1. bright, red large clots during micturation for 6 days while bending forward along with swelling of the right hypochondrium.

TREATMENT AND FOLLOW-UP

By observing character of the haematuria and debility Arsenicum hydrogenisatum30c /2doses was selected on 08.02.16  for the first prescription. After prescribing there was mild to moderate symptomatic relief but no general improvement resulted after one week.

After that the case was retaken and analysis done. Symptoms were as follows:

  • Indifferent, desire to be alone, easily angered, avoids the society, zealous.
  • Memory is poor, can’t remember things
  • Though the patient is passing large clots in urine, still he is very cheerful and not debilitated.
  • Pale face, sunken cheeks, and emaciated, dry and parched lips
  • Burning sensation in hypogastrium
  • Thirstless
  • Stool: Constipated, twice daily, Mucous present, has to

strain much to defecate.

On the basis of relevant and intensified generalities Acid phos 200c /2doses was prescribed. Then in subsequent follow-ups, placebo was given (from 15.02.16 to 06.05.16) for 8 visits and then gradual marked reduction of haematuria with a general improvement was noted.

CONCLUSION:

The medicine was selected on the basis of the totality of symptoms and through individualization and it covered the patients’ miasmatic background.  It had the capability to cure the patient at the deeper level leading to permanent restoration of health. Successful treatment of this case of haematuria demonstrates the importance of mental and physical generals with other parts of the anamnesis.

REFERENCES:

  1. Spetie, DN.; Nadasdy, T.; Nadasdy, G.; Agarwal, G.; Mauer, M.; Agarwal, AK.; Khabiri, H.; Nagaraja, HN.; et al. (Mar 2006). “Proposed pathogenesis of idiopathic loin pain-hematuria syndrome”.Am J Kidney Dis 47 (3): 419–27.doi:1053/j.ajkd.2005.11.029PMID 16490620.
  2. Hematuria CausesOriginal Date of Publication: 15 Jun 1998. Reviewed by: Stacy J. Childs, M.D., Stanley J. Swierzewski, III, M.D. Last Reviewed: 10 Jul 2008
  3. Allen, H.C; Keynotes and Characteristics with Comparisons of Some of the Leading Remedies of the Materia Medica with Bowel Nosodes(2014); B.JAIN Publishers (P) Ltd. ISBN 978-81-319-0124-3
  4. Boericke, William; Pocket Manual of Homoeopathiic Materia Medica & Repertory(2011); B JAIN Publishers (P) Ltd. ISBN 978-81-319-0128-1
  5. Clark, John Henry; A Dictionary of Practical Materia Medica(2010); B JAIN Publishers (P) Ltd. ISBN 978-81-319-0261-5

About the author

Ashim Kumar Das

Ashim Kumar Das

Dr. Ashim Kumar Das - H.O.D, Dept. of Surgery Mahesh Bhattacharyya Homoeopathic Medical College & Hospital, Doomurjala, Howrah-04, West Bengal

Abhijit Dutta

Dr. Abhijit Dutta, B.H.M.S

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