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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Blood In Urine, Fever. High RBC. Solution?

I noticed blood in my urine 3 months back. There was visible blood for 2 days and on the third day it subsided. I did not take a urine test then as I was taking medicines because of cold/mild fever . The same thing repeated a few days back (with cold/mild fever) and this time I did a routine urine test as well as culture and sensitivity test (no medicines were taken then). Everything was normal except for RBC in it (40-60 RBC/HPF). however, I took the urine sample for the test on the third when it had already subsided. I have no pain at all. There is one thing common in both the cases. Approximately after around 10 days I had my normal menstruation . Can you please throw me some light on this problem?
Sat, 30 Mar 2013
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General & Family Physician,  's  Response
Hello and welcome to HCM.

Thank you for your query.

In my opinion, as you have gone about all the required initial investigations (i.e. a urinalysis, a urine culture, etc.), the best follow-up investigation now would be an abdominal and pelvic ultrasound.

Blood in the urine could be a problem relating to the renal system. Please go about the ultrasound for more clarity on your condition. 40-60 RBC/HPF is not normal at all and further evaluation will have to be conducted to rule out/diagnose all possiblities. Even more as you did not have your periods at that particular time.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you.

Best wishes.
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Internal Medicine Specialist,  Dr. Maruti Karale's  Response
Hello!
Thanks for writing to us.

RBCs of 40-60 indicates significant hematuria (blood in urine).This needs to be urgently evaluated and treated.

Following possibilities can be considered:
-Urinary tract infection
-Bladder stones
-Kidney stones or ureter stones
-Acute Glomerulonephritis
-IgA nephropathy ("Berger's disease")
-Alport syndrome
-Trauma
-Tumors and/or cancer in the urinary system, e.g.bladder cancer or renal cell carcinoma Kidney diseases
-Benign familial hematuria
-Paroxysmal nocturnal hemoglobinuria
-Tuberculosis of urinary tract or kidney.

I would like to suggest USG KUB,urine examination for proteinuria,casts,WBCs,Morphology of RBCs,CT scan of KUB ,and Nephrologist opinion for clinical correlation.

Hope this could help you.

Wish you good health.
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Blood In Urine, Fever. High RBC. Solution?

Hello and welcome to HCM. Thank you for your query. In my opinion, as you have gone about all the required initial investigations (i.e. a urinalysis, a urine culture, etc.), the best follow-up investigation now would be an abdominal and pelvic ultrasound. Blood in the urine could be a problem relating to the renal system. Please go about the ultrasound for more clarity on your condition. 40-60 RBC/HPF is not normal at all and further evaluation will have to be conducted to rule out/diagnose all possiblities. Even more as you did not have your periods at that particular time. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you. Best wishes.