All issues > Volume 31(11); 1988

Original Article

J Korean Pediatr Soc. 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

Received: June 7, 1988;  Accepted: July 25, 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.

Keywords :Urinary RBC morphology, Phase contrast microscope, Wright's staining, Hematuria