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At least 163 records · Page 9Linked to original sources
PubMed1998

[Value of phase-contrast microscopy in the etiological diagnosis of hematuria in adults. Part II: Analysis of factors modifying morphology of erythrocytes in urine sediment].

In 41 patients with glomerular hematuria diagnosed by renal biopsy no correlation between intensity of tubulo-interstitial changes and range of dysmorphic erythrocytes (E) in phase-contrast microscopy (PCM) was found. However, such correlation existed in the case when acanthocytes in PCM were detected. From factors of potential influence on the morphology of E such as value of proteinuria, glomerular filtration rate, crystalluria, osmolarity and pH of urine, none had any significant role in changing the morphology of E of glomerular as well as of non-glomerular origin.

Adult↗
PubMed1993

[Clinical value of studying hematuria using phase-contrast microscopy].

To evaluate the examination of urine erythrocytes with a contrast phase microscope for the etiological diagnosis of haematuria (erythrocytes > 10/mm3 of non centrifuged urine) the charts of 84 patients with haematuria were reviewed. A nephrological origin had been established with certainty in 56 cases with a renal biopsy and an urological origin was also established with certainty in 28 cases thanks to appropriate radiological, endoscopical and pathological examinations. The morphological criteria of the erythrocytes deformation were those of Birch and Fairley but the quantitative criteria of these authors (either 80 or 100%) were found to be of no value. By successive approaches the threshold of 20% of deformed erythrocytes was selected and found to be the best criterion for diagnosing glomerular hematuria: the sensitivity of the test is then 73% and its specificity 60%. As these results were relatively modest, conditions which decrease the percentage of deformed erythrocytes were excluded to improve the sensitivity, such as macroscopic haematuria and also examinations made during the 6 hours following furosemide administration whereas conditions which increase the percentage of deformed erythrocytes and which are easily diagnosed such as urinary infections, lithiasis and renal insufficiency associated with an uropathy were excluded in order to improve the specificity. Then the examination has a sensitivity and a specificity of 90% which makes it clinically relevant, authorizing a wait and see attitude in case there is an isolated microscopic haematuria of glomerular type.

Diagnosis, Differential↗
PubMed2003

Comparison of red blood cell volume distribution curves and phase-contrast microscopy in localization of the origin of hematuria.

OBJECTIVES: To determine the ability, reliability, and accuracy of urinary red blood cell volume distribution curves obtained with the use of an autoanalyzer to identify the origin of isolated microscopic hematuria and compare the results with those obtained with phase-contrast microscopy (PCM). METHODS: A prospective evaluation was performed in 45 patients with glomerular or nonglomerular microhematuria detected by urinalysis, PCM, radiologic evaluation, endoscopy, and, sometimes, renal biopsy. Urine samples were analyzed in an electronic particle-size analyzer, and the tests were repeated to assess reliability. The kappa correlation coefficient was used to assess reliability and to compare the results with the final diagnosis and with those obtained with PCM. RESULTS: Of the 28 patients who had a single definite cause of hematuria, 16 had glomerular bleeding and 12 nonglomerular bleeding. The origin of hematuria was correctly identified by the autoanalyzer in 60.7% of cases. A statistically significant correlation was found with the final diagnosis (kappa = 0.433, P = 0.048). The reliability was excellent (kappa = 0.917, P <0.0001). Of 16 patients with glomerulonephritis, 10 (62.5%) were correctly identified by PCM and 14 (87.5%) by the autoanalyzer. In 12 patients with nonglomerular bleeding, PCM was accurate in 7 (58%) and the autoanalyzer in 3 (25%). The results were statistically correlated with the findings of PCM (kappa = 0.327, P <0.00001). CONCLUSIONS: The use of an autoanalyzer is easy, reproducible, and noninvasive. It provides reliable information to orient the diagnosis toward glomerular or nonglomerular bleeding. It is as accurate as PCM for screening for the source of hematuria.

Adult↗
PubMed1987

Phase contrast microscopy of the urine sediment for the diagnosis of glomerular and nonglomerular bleeding-data in children and adults with normal creatinine clearance.

In a pediatric and in an adult group of patients with hematuria and normal creatinine clearance overnight urine examination was carried out on 2 nonconsecutive days by means of phase contrast microscopy by two independent observers working in two different institutions. In this way it was possible to distinguish between patients on the basis of dysmorphic (glomerular) and isomorphic (nonglomerular) red cells in urine and to correlate the findings with the final diagnosis. A clear-cut indication (more than 80% of isomorphic and/or dysmorphic red cells) was obtained in 163 patients (102 of pediatric age) and final diagnosis of hematuria correlated with red-cell microscopy findings in 96.4% of glomerular diseases and in all cases of nonglomerular origin. Mixed hematuria (50-75% of dysmorphic red cells) was found in 2 cases of renal tuberculosis, 2 cases of polycystic kidney disease and in 1 child with viral meningoencephalitis with a bladder stone. The data indicate that the method is safe and accurate but further experience must be gathered for the many etiologies of glomerular and nonglomerular diseases hitherto not studied.

Adolescent↗
PubMed1987

[Diagnosis of glomerular and non-glomerular erythrocyturia using phase contrast microscopy of the urine sediment].

Recently the appearance of deformed polymorphous erythrocytes in the urinary sediment has been described as characteristic of glomerular bleeding. We studied 30 patients with histologically confirmed glomerular disorders and 25 patients with urological diseases and with hematuria. In the sediment of 10 ml urine 200 erythrocytes were counted under phase-contrast microscopy and evaluated relative to their morphology. The number of glomerular erythrocytes was expressed as a percentage. In all groups of glomerular disorders (mesangial-proliferative, membranous and membrano-proliferative glomerulonephritis, focal segmental glomerulosclerosis, glomerulonephritis of systemic disease, thinning of the glomerular basement membrane) the percentage of glomerular erythrocytes varied widely between 2 and 100%. In 7 cases less than 10% of glomerular erythrocytes were found. There was no correlation between the percentage of glomerular erythrocytes and the degree of renal insufficiency, hematuria or proteinuria. On the other hand, in patients with hematuria from the lower urinary tract, erythrocytes were uniformly non-glomerular in shape (95-100%). We conclude that 10-20% or more of glomerular erythrocytes in the urinary sediment are a good indicator of glomerular disease, whereas lower figures do not definitely rule out a glomerular origin for hematuria.

Erythrocytes↗
PubMed1983

Evaluation of glomerular and nonglomerular hematuria by phase-contrast microscopy.

Glomerular and nonglomerular origins of hematuria may be identified by assessment of the shape and size of the excreted red blood cells. We examined 380 urine specimens from 179 children with hematuria (greater than or equal to 3500 RBC/minute) with phase-contrast microscopy. In 106 cases, the cause was known; the results agreed with the clinical, histologic, and laboratory diagnosis in 63 of 65 subjects (97%) with glomerulopathies and in 39 of 41 (95%) with nonglomerular hematuria. Casts were found in 54% of the specimens from the children with definite glomerular hematuria. Phase-contrast microscopic examination of red blood cells in the urine is a simple, inexpensive, and noninvasive technique that permits an accurate distinction between glomerular and nonglomerular bleeding in pediatric patients.

Adolescent↗