Erythrocyte morphology under phase contrast microscopy in haematuria

Fresh urine samples from twenty patients with macroscopic haematuria were examined by phase contrast microscopy to study the erythrocyte morphology. Other appropriate investigation like - renal biopsy in suspected glomerulonephritis and appropriate urological investigations in other cases to prove the site of origin of erythrocyte were done in all cases. Changes in erythrocyte morphology were observed in all the 12 patients with histological evidence of proliferative glomerulonephritis. These changes included extrusion of cell cytoplasm (39.5%), 'Doughnut' cell (26.5%) budding cell (15%) and cell membrane rupture with loss of cytoplasm (15%). Overall 83.3% of the erythrocytes showed some morphologic change or the other. In 8 patients where bleeding was into the pelvicalyceal system, ureter or bladder, 95% of RBCs showed no discernible morphologic change. It is concluded that the morphological changes in the erythrocyte identified under the phase contrast microscope can help to differentiate between glomerular and non glomerular causes of bleeding.