揭开隐藏的形状:尿液沉积物中不寻常的红细胞形态
Oscar D Pons-Belda1, Santiago Mariño-Lopez2, Paloma Livianos-Arias-Camison2
1Department of Clinical Analysis, Hospital Can Misses, Eivissa, Spain.
Clinica chimica acta; international journal of clinical chemistry
|October 21, 2025
概括
尿液中碎片化的红血细胞 (血清细胞),很少见,在患有非典型血清性尿素综合征 (aHUS) 的患者中检测到. 这一发现突出了尿液显微镜的重要意义.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 血液学 血液学 血液学
- 病理学 病理学 病理学
背景情况:
- 晶状体细胞 (碎片化的红细胞) 通常在血液涂抹中发现,表明微血管病性血液溶解性贫血 (MAHA) 和血栓性微血管病 (TMA).
- 它们在尿液中的存在非常罕见,在医学文献中仅有有限的文献.
研究的目的:
- 报告第一个在排尿中检测到的分裂细胞与非典型的血清性尿素综合征 (aHUS) 相关的病例.
- 强调尿沉积物显微镜在识别TMA相关病理方面的诊断实用性.
主要方法:
- 一个产后妇女的病例报告,在剖腹产后患有严重贫血,血小板缺血和急性损伤.
- 用手动相对比显微镜进行尿液分析,以确定非典型的红细胞形态.
- 血液涂抹检查,ADAMTS13活性测定和抗体测试以区分TMA亚型.
- 用eculizumab (补充封锁) 治疗疑似HUS的患者.
主要成果:
- 患者出现了与TMA一致的症状,包括血管内血解,贫血,血小板减少和急性损伤.
- 尿液显微镜检测显示了血清细胞和其他非典型的红细胞形式,以及血和蛋白尿.
- 在ADAMTS13测试中排除了血栓性血栓塞性紫 (TTP),支持了aHUS.US的诊断.
- 治疗eculizumab导致迅速的血液和的恢复.
结论:
- 在排尿中检测出血清细胞是一个与aHUS相关的新发现.
- 这种现象在机理上是合理的,因为膜过屏障在脏微血管病变中被破坏.
- 尿沉积物显微镜仍然是一个有价值的诊断工具,用于发现TMA的重要特征.
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