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Urology/Possible IgA and contrast CT scan


My daughter (23) is being evaluated by a urologist for periodic blood and blood clots in her urine. She first had these episodes two years ago.  The typical pattern for these episodes is her coming down with a cold, followed by blood in her urine and often flank pain. Tests for infection following the episodes are negative. Previous CT scans have shown nothing. The urologist has ordered a CT scan and a CT scan with contrast. My questions: 1) Could this be IgA? and 2) If it is IgA, should she have the contrast CT scan or is this a risk to her kidneys? Should she see a nephrologist first before she has the contrast scan?
Thank you for your time.


A typical evaluation for blood in the urine is intended to diagnose things like tumors, polyps and stones.  Blood that occurs only after an infection of some sort can be immunological, but this would not prevent the appearance of these other problems.  We would typically do a CT urogram (without and with IV contrast) and consider a cystoscopy to clear her urologically.  If no other cause is found, then a nephrology consult may be reasonable.  There should not be any problem with the IV contrast as long as her overall kidney function is acceptable.

We typically do not recommend a nephrology consultation before a urology consult for visible bleeding in the urine.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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