Child Abuse in Medical Setting Presenting as Gross Hematuria: Diagnosis by DNA Short Tandem Repeats

Two sisters, aged 15 and 13 years, had previous epithelioid angiomyolipoma of the kidney and suspected thin basement membrane disease, respectively. They presented with 2 years of gross hematuria and new-onset heavy proteinuria. Extensive investigations failed to find an overt cause of their urinary manifestations. The diagnosis of child abuse in a medical setting was confirmed by DNA short tandem repeats analysis, which are the first documented cases in which factitious hematuria was thus diagnosed. Complex forms of child abuse in a medical setting may require forensic tests such as DNA short tandem repeats analysis for diagnosis. * Abbreviations: CAMS — : child abuse in a medical setting HPF — : high power field Ig — : immunoglobulin RBC — : red blood cell STRs — : short tandem repeats TMBD — : thin basement membrane disease