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Is Erythrocytes reading 5 X10^6/L normal or would there be a need for an Ultrasound?

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Hi, My husband has just received his pathology report on a urine sample which has been conducted for Australian Immigration purposes. He was found to have a trace of blood in his urine. Everything on his report says "nil" except for the Erythrocytes which says; 5 X10^6/L (<10) Is this normal or is it likely he will be referred for an ultrasound? Many thx, XXXX
Posted Sun, 22 Dec 2013 in Urinary and Bladder Problems
Answered by Dr. Aditya Bhabhe 29 minutes later
Brief Answer: See detailed answer Detailed Answer: Hi XXXXXXX Thank you for sending in your query. The presence of more than 5 RBCs (or erythrocytes) per hpf (high power field) is considered abnormal. If your husband has had no previous kidney or bladder problems and is currently asymptomatic, I would repeat the urinalysis to confirm if he really has erythrocytes in the urine. If there are RBCs in the second test as well then he would require further investigations to determine the cause. The source of erythrocytes can be anywhere in the kidneys, ureter, bladder or urethra. The cause can be infection, stones, diseases of the kidney like IgA Nephropathy or tumors. An ultrasound of the kidneys and bladder should be reasonable first test. Hope this was helpful. I will be happy to provide answers to any other questions which you may have. Regards Dr Bhabhe
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Follow-up: Is Erythrocytes reading 5 X10^6/L normal or would there be a need for an Ultrasound? 1 hour later
Thank you Dr Bhabhe. His second test also came back showing the same result. He does a lot of weight training and we have heard that this can lead to blood in his urine. Is this true? His doctor said there is no need for an ultrasound but I am worried that Australian Immigration doctors may ask for one. If over 5 is considered abnormal, does that mean that 5 is normal? Many thx, XXXX
Answered by Dr. Aditya Bhabhe 49 minutes later
Brief Answer: See detailed answer Detailed Answer: Hi XXXXXXX I will answer your questions one by one: 1) Exercise and hematuria: You are right. Strenuous exercise can cause RBCs in urine. A simple way to determine if this is the cause is to stop the exercise for 1 week and repeat the urinalysis. If there are no RBCs we could assume that exercise is the cause. If RBCs persist after a week of rest we have to look for other causes. 2) Actually it is 5 or more RBCs per hpf. Some doctors believe that more than 3 RBCs/hpf is abnormal. However we do not have a consensus yet. So if Urine persistently shows 5 RBCs I will not call it normal. Hope this helps Dr Bhabhe
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