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A 53-year-old female asked:

rbc and wbc casts in urine. right flank pain. no fever. pyelonephritis diagnosis but dr told me he wasn't sure that maybe something more going on. ideas?

1 doctor answer3 doctors weighed in
Dr. Ed Friedlander
Pathology 44 years experience
This is serious: A nephrologist or pathologist needs to look at the urine to confirm the presence of red cell casts. If they are indeed present, you have glomerulonephritis of some sort. Since you state that you have systemic lupus, this is the obvious first consideration, and the presumptive (and likely) diagnosis is lupus glomerulonephritis. A nephrology referral is in order now.

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Last updated Jul 12, 2020

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