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Urinary Red Blood Cell Morphology in Hematuria.

Journal of the Korean Pediatric Society 1988;31(11):1460-1467.
Published online November 30, 1988.
Urinary Red Blood Cell Morphology in Hematuria.
Hong Jin Lee1, Chang Yeon Lee1, Hae Il Cheong1, Yong Choi1, Kwang Wook Ko1, Myung Hee Park2
1Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
2Department of Clinical Pathology, College of Medicine, Seoul National University, Seoul, Korea
혈뇨의 감별진단을 위한 소변내의 적혈구형태에 관한 연구
이홍진1, 이창연1, 정해일1, 최용1, 고광욱1, 박명희2
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 임상병리학교실
Received: 7 June 1988   • Accepted: 25 July 1988
Abstract
We have studied morphological alterations in urinary RBC as a tool for the differential diagnosis of hematuria in children, that is, differentiation of glomerular bleeding from nonglomerular bleeding, and the results were as follows; 1) Urinary RBCs from glomerular diseases showed higher rate of dysmorphism (84.3±16.8%), and those from nonglomerular diseases did lower one (15.2 ±12.9%) with phase contrast microscopic examination. 2) Simple light microscopic examination after Wright’s staining revealed nearly same results with phase contrast microscopic examination. 3) Accordingly, higher than 60% of dysmorphism for glomerular bleeding and lower than 30% for nonglomerular bleeding could be proposed as discriminating levels with sensitivity of higher than 80 % and specificity of higher than 95%. 4) Since, however, 6 children with glomerular diseases showed low rate of dysmorphism during acute stage with massive hematuria, regular follow-up examinations for 1—2 weeks should be obtained before imprudent interpretations. In conclusion, the morphological examination of urinary RBC is a simple and accurate method for differentiating glomerular bleeding from nonglomerular bleeding in patients with hematuria. This examination can be done with simple light microscope after Wright*s staining as accurately as with phase contrast microscope.
Key Words: Urinary RBC morphology, Phase contrast microscope, Wright's staining, Hematuria


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