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What causes elevated white blood cells, hematuria and chronic pain in the flank area when sleeping?

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Spine Surgeon
Practicing since : 1998
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What conditions might cause elevated white blood cells, hematuria and chronic pain in the flank area when sleeping? Have had these conditions every blood test for the last 3 years. CT scan and MRI showed nothing abnormal along with nothing showing when I went to a urologist.
Tests performed with no results that explain the concerns:
CT scan
scope by urologist to rule out bladder and urinary tract concerns
Visit with kidney specialist
physical therapy to reduce pain in back with no improvement following course of treatment
Posted Sat, 24 Nov 2012 in X-ray, Lab tests and Scans
Answered by Dr. S K Mishra 6 hours later

Thanks for the query.

As all the radiological test and scopes are normal, it is indeed a difficult situation. A few possibilities that need to be excluded are:
1. Renal tuberculosis - It needs first priority if you are from subcontinental community or had exposure to tuberculosis / visited tropical land with high prevalence.
2. Similar atypical presentation of chronic and low grade disorder / infection common in your state.

If all investigations done so far have failed to give enough clues, I feel you will need a renal biopsy as the last step. This will establish any links between renal disease including renal tuberculosis with your symptoms.

I am glad to know you have a visit with a nephrologist. You can expect some answers following the visit.

Hope I was helpful. Let me know if there are other enquiries.

Above answer was peer-reviewed by
Follow-up: What causes elevated white blood cells, hematuria and chronic pain in the flank area when sleeping? 6 hours later
I live in Kansas and have not traveled to a community where renal to is a concern. My tb test this summer for work was negative.

The nephrologist said not to worry about the hematuria as they ruled out everything to be concerned about when they did the ct and MRI. They thought I had an infection causing the elevated WBC and were not overly concerned, just gave me antibiotics.. I'm no longer seeing this dr. I am only seeing my sleep. I do have stiffness in my hip and legs when I try to get up and go after long periods of sitting but recover quickly once I get moving. The pain when I try to sleep is causing me the most issue as I only get about 3 hours of restful sleep before I wake up in pain. I also have urinary frequency and when I wake up from the pain I then have to get up and use the restroom.

I'm not sure what specialist to see and try to figure out what is wrong. I know that for the last 3 years I have been consistently in pain, my labs have consistently reflected most everything is normal except large amounts of microscopic blood in my urine and elevated white blood cell count of 0000. My kidney and liver tests reflect normal functioning.

Could some type of autoimmune disorder be causing my symptoms? What type of specialist should I see to help me find a diagnosis and effective course of treatment?
Answered by Dr. S K Mishra 2 hours later
Yes there is a Possibility. You can get a referral from primary to a clinical immunologist. Few tests will help them rule out autoimmune disorder as well.

How about a Gynecologist consult too? Ofcourse your primary physician can do a necessary referral.

They have a better advantage than me to understand the problem I can guide you only.

Thank you.
Dr. Misra.

Above answer was peer-reviewed by
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