Two plus signs for occult blood in red blood cells

In the urine test, if there are two plus signs for red blood cell occult blood, it means that the patient has hematuria. Hematuria is a relatively dangerous symptom because it may indicate that the patient has kidney or urinary tract disease, or it may be a systemic disease or a problem with an adjacent organ. Here are some common diseases that may cause hematuria.

1. Kidney and urinary tract diseases

(1) Inflammation: acute and chronic glomerulonephritis, acute and chronic pyelonephritis, acute cystitis, urethritis, urinary tract tuberculosis, urinary tract fungal infection, etc.

(2) Stones in the renal pelvis, ureter, bladder, urethra, or anywhere else can scratch the urothelium as they move, which can easily cause hematuria and secondary infection. Large stones can cause urinary tract obstruction and even renal damage.

(3) Tumors Malignant tumors in any part of the urinary system or in adjacent organs that invade the urinary tract can cause hematuria.

(4) Trauma refers to violent injury to the urinary system.

(5) Congenital polycystic kidney disease, congenitally thin glomerular basement membrane, nephritis, and the nutcracker phenomenon (this disease is caused by congenital vascular malformations that cause the left renal vein running between the abdominal aorta and the superior mesenteric artery to be squeezed, causing persistent microscopic hematuria. The right renal vein flows directly into the inferior vena cava, while the left renal vein must pass through the angle formed by the abdominal aorta and the superior mesenteric artery to flow into the inferior vena cava. Normally, this angle is 45° to 60°. If this angle is congenitally too small or filled with mesenteric fat, enlarged lymph nodes, or peritoneum, it can cause the nutcracker phenomenon. Diagnosis is mainly based on CT, B-ultrasound, and renal venography. Treatment requires surgical correction).

2. Systemic Diseases

(1) Hemorrhagic diseases: thrombocytopenic purpura, allergic purpura, hemophilia, leukemia, malignant histiocytosis, aplastic anemia, etc.

(2) Connective tissue diseases: systemic lupus erythematosus, dermatomyositis, polyarteritis nodosa, scleroderma, etc.

(3) Infectious diseases: leptospirosis, hemorrhagic fever, filariasis, infectious bacterial endocarditis, scarlet fever, etc.

(4) Cardiovascular diseases: congestive heart failure, renal embolism, and renal vein thrombosis.

(5) Endocrine and metabolic diseases: gouty kidney, diabetic nephropathy, and hyperparathyroidism.

(6) Physical and chemical factors such as food allergies, radiation exposure, drugs (such as sulfonamide, phenol, mercury, lead, arsenic poisoning, large-scale infusion of mannitol, glycerol, etc.), poisons, and after exercise.

3. Diseases of adjacent organs

Tumors from the uterus, vagina, or rectum that have invaded the urinary tract.