The most common disease for urinary occult blood (++++) may be the occurrence of IgA nephropathy, combined with urinary protein (+), and possibly chronic nephritis. The presence of primary diseases, such as systemic lupus erythematosus, dry syndrome, allergic purpura or multiple myeloma, can also show occult blood (++++) in urinalysis. In addition to these factors, urinary occult blood (++++) can also occur in physiological conditions such as exertion, staying up late, exercise or in combination with upper respiratory tract infections, gastroenteritis and related conditions such as heart failure and hypoperfusion; the presence of The presence of systemic disorders of blood clotting can also show occult blood (++) in urine tests.