[Volumetric analysis of urinary erythrocytes in the etiological diagnosis of hematuria].
Intravenous pyelography and cystography may fail to localize the origin of haematuria. Microhaematuria is known to be present in 2 to 10 percent of the general population, usually without pathological consequences. Study of red cell morphology by phase contrast microscopy is effective in distinguishing between "glomerular" (from renal tissue) and "non-glomerular" (from urinary tract) erythrocytes, but this technique is not currently available in all laboratories. Urinary blood cell volume analysis has been presented as a simple and automatic alternative method. We compared these two techniques in 100 cases of haematuria of various origins. The cut-off point between glomerular and non-glomerular erythrocytes was set at 71 fl. Phase contrast microscopy always confirmed the clinical and/or histological diagnosis, but volume analysis did not: mean erythrocyte volume of glomerular origin was 66.6 +/- 10.4 fl, while non-glomerular volume was 94.5 +/- 17 fl (P < 0.001); cell volume analysis was confirmative in only 72 percent of all diagnoses (65 percent of microhaematurias, 83 percent of macrohaematurias); sensitivity was 65 percent and specificity 85 percent for glomerular erythrocytes. Due to poor performance, urinary red volume analysis is not an acceptable alternative method to phase contrast microscopy when searching for the site of bleeding.
Jean
G
G
Service de Néphrologie, Hémodialyse, Transplantation, Centre Hospitalo-Universitaire Lyon Sud, Pierre Bénite.
François
B
B
Drai
J
J
Pellet
H
H
Durieu
I
I
Cahen
R
R
Trolliet
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004912:Erythrocytes / Q000166:cytology*; D005260:Female; D005922:Glomerulonephritis, IGA / Q000150:complications; D006417:Hematuria / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011469:Prostatic Diseases / Q000150:complications; D014514:Ureteral Calculi / Q000150:complications
Analyse volumétrique des hématies urinaires dans le diagnostic étiologique des hématuries.