Lupus and High White Blood Cells in Urine

posted in Nephritis, kidneys, urinary tract on May 23, 2023 by

Updated December 25, 2023

What is Lupus?

Lupus is an autoimmune disease that occurs when the immune system attacks healthy tissues in the body. This can result in inflammation and damage to various organs, such as the skin, joints, kidneys, heart, and lungs. Lupus symptoms can vary widely depending on the individual but may include fatigue, joint pain, skin rash, fever, and organ damage. One of the most common organs involved in lupus is the kidneys (called lupus nephritis). Lupus nephritis can be one potential cause of high white blood cells in the urine.

What is High White Blood Cells in Urine?

White blood cells (also called leukocytes) are an important part of the immune system that help fight infection and disease. Normally, there should be very few white blood cells in the urine. When there are high levels of white blood cells in the urine, it may indicate an infection or inflammation in the urinary tract. However, high white blood cells (WBC) in urine can also be a sign of kidney damage or disease. Another potential cause is due to contamination. If someone does not collect their urine sample properly, white blood cells from surrounding tissue (the penis or vaginal area) can end up in the urine sample, causing an incorrect result. It is important for all lupus patients to know how to collect a urine sample properly.

Lupus and High WBC in Urine

Lupus patients are at a higher risk of developing kidney problems, including glomerulonephritis (also called lupus nephritis), a type of kidney inflammation. This can cause protein and blood cells to leak into the urine, leading to a condition called proteinuria (excessive protein in the urine). Proteinuria can be detected through a urine test, and if left untreated, can lead to kidney damage and failure.

High WBC in urine can also be a sign of infection (urinary tract infection or UTI). The urine usually contains bacteria (bacteriuria) when there is a UTI, in addition to having high WBC in the urine. If left untreated, this can lead to kidney damage and further complications.

Diagnosing and Treating High WBC in Urine in Lupus Patients

Since lupus nephritis occurs so often in systemic lupus erythematosus (in up to 45% of patients), lupus experts usually want a urine sample every 3 months. They are primarily testing for proteinuria, which is seen in 100% of lupus nephritis patients. If high WBC levels are detected, further testing may be needed to determine the underlying cause. This may include additional urine tests (especially a urine culture), blood tests, and imaging tests such as a kidney ultrasound.

Treatment for high WBC in urine in lupus patients will depend on the underlying cause.

If you have lupus and experience symptoms such as frequent urination, painful urination, or cloudy urine, you could have a UTI. It is important to speak with your healthcare provider as soon as possible. Prompt antibiotic treatment is important. They may also recommend a urine test to check for bacteria and test different antibiotics on the bacteria to see what works best.

If a kidney biopsy is done and shows lupus nephritis, medications (such as Benlysta, Lupkynis, mycophenolate, or cyclophosphamide) are needed to reduce inflammation and protect kidney function. In some cases, more aggressive treatments such as dialysis or a kidney transplant may be needed.

Preventing High WBC in Urine in Lupus Patients

While it may not be possible to completely prevent kidney problems in lupus patients, there are steps that can be taken to reduce the risk. These may include:

Practice everything listed in Dr. Thomas’ “Lupus Secrets.”
Read and do everything discussed in Dr. Thomas’ blog post “How to Succeed after a Lupus Diagnosis.”
Regular check-ups with a healthcare provider to monitor kidney function and to collect a urine sample to ensure there is no proteinuria (the earliest finding in lupus nephritis).
Taking medications as prescribed to manage lupus symptoms and prevent kidney damage
Maintaining a healthy lifestyle, including a balanced (anti-inflammatory) diet and regular exercise
Avoiding smoking

High WBC in urine can be a concerning finding for lupus patients, as it may indicate kidney inflammation or infection. It is important to work closely with a healthcare provider to monitor kidney function and urine samples and detect any issues early on. With proper management and treatment, lupus patients can reduce their risk of kidney damage and maintain a good quality of life.