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[What is the practical attitude toward isolated microscopic hematuria?]
1Laboratoire central d'examens biologiques, Hôpital cantonal universitaire, Genève.
Nephrologie
|January 1, 1993
Summary
Phase contrast microscopy helps differentiate glomerular from non-glomerular hematuria. Differentiating erythrocyte types guides further investigation for microscopic hematuria, avoiding unnecessary invasive procedures.
Area of Science:
- Nephrology
- Urology
- Diagnostic Microscopy
Context:
- Isolated asymptomatic microhematuria often prompts extensive investigations.
- Determining the origin of hematuria is crucial for appropriate patient management.
- Non-invasive diagnostic methods are preferred when feasible.
Purpose:
- To outline a practical approach for evaluating isolated microscopic hematuria.
- To highlight the utility of phase contrast microscopy in differentiating hematuria origins.
- To establish criteria for further investigations based on erythrocyte morphology.
Summary:
- Phase contrast microscopy identifies dysmorphic (glomerular) or isomorphic (non-glomerular) erythrocytes in urine sediment.
- Dysmorphic erythrocytes (>10/µL) suggest glomerular disease; <10/µL is physiological, often requiring no further workup.
- Isomorphic erythrocytes indicate non-glomerular hematuria, warranting further urological investigation (e.g., ultrasound, urine cytology).
Impact:
- Enables clinicians to avoid unnecessary invasive procedures for physiological microhematuria.
- Facilitates timely diagnosis and management of potentially serious urological conditions.
- Improves diagnostic accuracy for microscopic hematuria through standardized microscopy techniques.