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Updated: Aug 16, 2026
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Published on: June 30, 2018
Dysmorphic erythrocytes and G1 cells as markers of glomerular hematuria
1Department of Laboratory Medicine, University Hospitals, Leuven, Belgium. zahur.zaman@uz.kuleuven.ac.be
Insights
Neither G1 cells nor dysmorphic erythrocytes alone reliably diagnose glomerular hematuria in children. Combining both tests is necessary for accurate differentiation of glomerular and non-glomerular hematurias, improving diagnostic sensitivity and specificity.
Area of Science:
- Nephrology
- Pediatric Urology
- Clinical Diagnostics
Background:
- Glomerular hematuria diagnosis in pediatric patients is crucial for identifying underlying kidney diseases.
- Dysmorphic erythrocytes and G1 cells in urine are potential biomarkers for glomerular bleeding.
- Accurate differentiation between glomerular and non-glomerular hematuria is essential for appropriate management.
Purpose of the Study:
- To evaluate the diagnostic utility of G1 cells and dysmorphic erythrocytes in pediatric glomerular hematuria.
- To determine the sensitivity and specificity of these markers for differentiating glomerular from non-glomerular hematuria.
- To assess the combined diagnostic performance of G1 cells and dysmorphic erythrocytes.
Main Methods:
- Analysis of urine samples from pediatric patients with biopsy-proven glomerulonephritis and non-glomerular renal diseases.
- Quantification of G1 cells and dysmorphic erythrocytes using counting chambers and urine sediments.
- Calculation of sensitivity and specificity for various cut-off values of G1 cells and dysmorphic erythrocytes.
Main Results:
- Individual G1 cell counts and dysmorphic erythrocyte percentages showed limited sensitivity and specificity for diagnosing glomerulonephritis.
- High cut-off values for G1 cells yielded high specificity but low sensitivity, while dysmorphic erythrocytes showed variable performance.
- Combining both markers improved diagnostic accuracy, but neither test alone was sufficient for reliable differentiation.
Conclusions:
- Neither G1 cells nor dysmorphic erythrocytes alone are adequate for reliably differentiating glomerular from non-glomerular hematuria in pediatric patients.
- A combination of both G1 cell percentage and dysmorphic erythrocyte count is required to achieve high sensitivity and specificity (>90%).
- Further research may explore optimized combined diagnostic strategies for pediatric hematuria.
Abstract:
We aimed to assess the utility of the percentage of G cells and dysmorphic erythrocytes in the diagnosis of glomerular hematuria in pediatric patients. We determined the percentage of dysmorphic erythrocytes and G1 cells in urine samples from patients with glomerulonephritis and other renal diseases of non-glomerular origin. There was excellent correlation and agreement between results obtained by counting the cells in counting chambers and in urine sediments. With cut-off values of > or =1%, > or =2%, > or =5%, and 10% for G1 cells, sensitivities for the detection of glomerulonephritis were 62%, 40%, 28%, and 10% and specificities were 89%, 95%, 95%, and 98%. For the dysmorphic erythrocytes cut-off values of > or =10%, > or =20%, 50%, and > or =90% gave respective sensitivities of 95%, 95%, 93%, and 62% and specificities of 24%, 34%, 43%, and 85%. In 38% of cases of biopsy-proven glomerulonephritis no G1 cells were found. For cut-off values of > or =50% dysmorphic erythrocytes and > or =1% G1 cells, the sensitivity and specificity were 60% and 91%. For cut-off values of > or =50% dysmorphic or > or =1% G1 cells, sensitivity and specificity were 93% and 44%. Our results show that neither the percentage of dysmorphic erythrocytes nor the G1 cell count is of adequate sensitivity and specificity to enable reliable differentiation of glomerular and non-glomerular hematurias. Both tests are needed to achieve >90% sensitivity and specificity.
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