Lab reveals leukocytosis with left shift on CBC and WBCs, casts, bacteria on urinalysis in classic presentations. Hemoglobinopathy patients may have increased incidence of kidney stones from increased excretion of uric acid. Acute papillary necrosis does occur with increased frequency in all of the sickle syndromes. Both can have very similar presentations with severe pain in back, flank, abdomen with radiation to groin and testicle. Exam shows hypoactive bowel sounds, guarding, CVA tenderness usually without fever.
Lab reveals some increase in white count without left shift.
UA positive for RBCs. Intravenous or retrograde pyelograms will establish the diagnosis. Diffuse or periumbilical, crampy pain which increases in severity. Exam shows decreased or absent bowel sounds, distension, fever, hypotension, guarding and rebound may be present. Lab shows leukocytosis with left shift, high anion gap acidosis, and increased amylase.