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Runner's macrocytosis is a phenomenon of increased red blood cell size as a compensatory mechanism for increased red blood cell turnover. The impact forces from running can lead to red blood cell hemolysis and accelerate red blood cell production. This can shift the ratio of red blood cells towards younger, larger cells.
The presence of hematuria, or blood in the urine, may indicate acute UTIs, kidney disease, kidney stones, inflammation of the prostate (in men), endometriosis (in women), or cancer of the urinary tract. In some cases, blood in the urine results from athletic training, particularly in runners. [citation needed]
Symptomatic treatment can be given by blood transfusion, if there is marked anemia. A positive Coombs test is a relative contraindication to transfuse the patient. In cold hemolytic anemia there is advantage in transfusing warmed blood. In severe immune-related hemolytic anemia, steroid therapy is sometimes necessary.
Hematuria can be classified according to visibility, anatomical origin, and timing of blood during urination. [1] [6]In terms of visibility, hematuria can be visible to the naked eye (termed "gross hematuria") and may appear red or brown (sometimes referred to as tea-colored), or it can be microscopic (i.e. not visible but detected with a microscope or laboratory test).
Treatment involves supportive care and may include dialysis, steroids, blood transfusions, or plasmapheresis. [1] [2] About 1.5 per 100,000 people are affected per year. [5] [1] Less than 5% of those with the condition die. [1] Of the remainder, up to 25% have ongoing kidney problems. [1] HUS was first defined as a syndrome in 1955. [1] [8]
The treatment of LPHS varies considerably from centre to centre. As the condition is rare and poorly understood, a widely adopted standard of care is not existent. [citation needed] Treatment of loin pain-hematuria syndrome (LPHS) typically consists of pain management. Narcotics or oral opioids may be prescribed to help control pain.
Dr. A. Thomas McLellan, the co-founder of the Treatment Research Institute, echoed that point. “Here’s the problem,” he said. Treatment methods were determined “before anybody really understood the science of addiction. We started off with the wrong model.” For families, the result can be frustrating and an expensive failure.
The mainstay of treatment is large quantities of intravenous fluids. [3] Other treatments may include dialysis or hemofiltration in more severe cases. [4] [10] Once urine output is established, sodium bicarbonate and mannitol are commonly used but they are poorly supported by the evidence. [3] [4] Outcomes are generally good if treated early. [3]