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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
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Experience:  14 years as clinician in the field of Family Practice
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I have a primary immune deficiency igg2, osteonecrosis from

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I have a primary immune deficiency igg2, osteonecrosis from prednisone, and multiple other illnesses. I am 37 y.o. but my main question is what could cause long term blood in urine? I've had blood in urine for several yrs now, sometime protein shows in urine also but not often. I had a cyctoscopy and r/o cancer but the blood is visually noticeable daily and my primary doctor tells me that it's just normal for me. I do have frequent urgency to per slot but rarely pass a decent amount. I also have pitted edema that comes and goes on a pretty regular basis, edema in hands n face as well. I am clueless what is causing the edema and the blood in urine. A few of my other doctors are not happy with knowing I'm still having the blood in urine. Any ideas on the blood in urine or the pitting edema? Any ideas would be grateful. Thank you. Kat Rich not sure if this info is needed but I do receive subq immunoglobulin infusions weekly and have a long medication list. Thank u again for your time.

Anthony Bray, MD : Hello!
Anthony Bray, MD : There are several possible causes for blood in the urine. This can occur for different reasons and the blood in the urinary tract can come from different sources ...
Anthony Bray, MD : your history overall sounds that you could have some form of kidney disease...
Anthony Bray, MD : I say this due to you having had protein in the urine at times, recurrent finding of blood in the urine and the edema being treated at times with Lasix...

Nothing has showed yet on my labs to signal any kidney issues but I'm so tired all the time. What tests should I request from my doctor or what kind of doctor should I see? Do you think it has anything to do with the edema problems?


Never had a urinary infection.

Anthony Bray, MD : you could have a firm of kidney inflammation due to one of a set of kidney diseases referred to as glomerulonephritis as one possible cause....
Anthony Bray, MD : This family of kidney disease should be evaluated by a nephrologist ( a medical kidney specialist)

I'm going to Boston's Lahey clinic next week. I just feel like they are missing something. My husband thinks I have lupus from the symptoms.

Anthony Bray, MD : certain causes of blood in the urine may include bladder disease , bladder cancer, kidney stones, cystic disease of the kidneys...
Anthony Bray, MD : some problems would be managed by a urologist ( a surgical specialist of the urinary tract)

They did do a cyctoscopy I believe that was the test and ruled out cancer

Anthony Bray, MD : other disease of the kidneys could include such things as IGA nephropathy, interstitial nephritis, lupus..

The urologist wrote the blood in urine off as normal since its been happening for several years. So I'm at a loss of what to do but other doctors tell me it is not normal.

Anthony Bray, MD : so there are a number of conditions that may cause blood to appear in the urine...
Anthony Bray, MD : some may cause the urine to appear bloody, some may not be visible and other times the urine may be tea colored...

Should I just take this info to the doctor I'm seeing in Boston maybe? My primary doctor I think is overwhelmed by the multiple issues n illnesses I have.


Yes, usually is visible on daily basis.

Anthony Bray, MD : Yes -- share all the info you can with the doctor that you see in Boston!!
Anthony Bray, MD : you need to be evaluated by a NEPHROLOGIST TOO!!
Anthony Bray, MD : A urologist only worries about a set of problems under their care and tend to walk away from kidney disease!!

Most doctors in my area have never treated my immune deficiencies before, I don't know if that has anything to do with it but I do have a lot of mid pain discomfort.

Anthony Bray, MD : There may be connection. That is hard to say for certain. I suspect that chronic kidney disease may be reason for your anemia though ! The kidneys stimulate the bone marrows production of red cells...

Ok, I will take all the info I can with me to Lahey clinic. Thanx so much for your time. I do feel a little better as I have argued for my primary doctor to send me to a kidney specialist. She has refused my request twice as she doesn't think it of any real importance.


My Mri show red marrow reconversion, could that play a part maybe?

Anthony Bray, MD : you may need erythropoietin injections periodically as a possibility( I don't have enough information to know if this is the case for you but it is a possible consideration)

What do those injections do?

Anthony Bray, MD : The injections hormonally stimulate red cell production from bone marrow. This is normally a kidney function. You may not be in need if added erythropoietin but it is not an unreasonable question at all!!
Anthony Bray, MD : Anemia is a potential complication if chronic kidney disease...
Anthony Bray, MD : Hopefully your kidneys are not in bad shape but it does sound that something has been going on...
Anthony Bray, MD : I think you are overdo to have it thoroughly checked out!!
Anthony Bray, MD : The main thing at this point for you I think is to get under the care if a good nephrologist!!
Anthony Bray, MD : I hope this is helpful for you!
Anthony Bray, MD : let me know if you have further questions and I will be happy to get back with you!

I will make sure to see a kidney specialist while in Boston, thank you very much for your time. I greatly appreciate your time.


I will and thanx again:)


Oh sorry, one more ?, What does the red marrow reconversion mean?

Anthony Bray, MD : You are very welcome! Take care and best regards XXXXX XXXXX!
Anthony Bray, MD : I am not familiar specifically with "red marrow reconversion" I would pose question to hematologist there...

Thank you Again. I will definitely get back to you once I have made it back from Boston's Lahey clinic.

Anthony Bray, MD : Ok that would be great! I would love update on your progress!
Anthony Bray, MD : take care! I hope things go well with regard to your care!

Than you thank you!

Anthony Bray, MD : i hope my responses have been helpful too. Positive feedback would be appreciated if this has been the case . Thank you and best regards,
Anthony Bray, MD : Anthony Bray MD
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