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Froukje L. Ubels, Gabe G. van Essen, Paul E. de Jong, Coen A. Stegeman, Exercise induced macroscopic haematuria: run for a diagnosis?, Nephrology Dialysis Transplantation, Volume 14, Issue 8, August 1999, Pages 2030–2031, https://doi.org/10.1093/ndt/14.8.2030
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Case report
A 42-year-old Caucasian female consulted our outpatient clinic because of exercise-related macroscopic haematuria. She has always been in excellent health, with different examinations during several years of her sporting career. A few months before, after return from a training camp in Denmark, she developed myalgia in the upper legs and frequently yellowish thin stool. After treatment with metronidazole, given because intestinal amebiasis was diagnosed in two participants of the same training camp, these complaints disappeared.
A few weeks later, reddish-coloured urine was observed after running, which she thought to be the result of menstruation, but tampons remained clean. Since that time, she consequently produced bright red-coloured urine after running, regardless of running distance or intensity. Every time, the urine returned to appear normal two or three voidings later. There was no dysuria or abdominal pain. The urine was bright, without grit or smell. There were no other complaints and she had never had this before. Our patient was working as a physiotherapist and usually ran 40–50 kilometres a week. She had already run a marathon three times. At physical examination, we found a healthy, slim woman with a blood pressure of 126/80 mmHg, heart rate of 60 beats per minute without abnormalities. Laboratory examination 30 min before and immediately after a 1.5 h run, are mentioned in Table 1. After, but not before exercise, many normal red blood cells without casts with only a trace protein and free haemoglobin was seen in the urine.
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