SIGNIFICANCE OF EOSINOPHILURIA IN URINARY SCHISTOSOMIASIS - A STUDY USING HANSEL STAIN AND ELECTRON-MICROSCOPY
SIGNIFICANCE OF EOSINOPHILURIA IN URINARY SCHISTOSOMIASIS - A STUDY USING HANSEL STAIN AND ELECTRON-MICROSCOPY
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DOI：
10.1093/ajcp/92.3.329
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发表时间：
1989-09-01
影响因子：
3.5
通讯作者：
HOMEIDA, M
中科院分区：
文献类型：
--
作者：
ELTOUM, IA;GHALIB, HW;HOMEIDA, M
本文对58例尿血吸虫病、20例急性肾小球肾炎和14例尿结石患者的尿存款涂片进行了汉氏染色。嗜曙红细胞尿见于所有尿血吸虫病患者（尿白色血细胞[WBC]中位数为0.73 [73%]）; 13例（65%）急性肾小球肾炎患者（尿WBC中位数为0.03 [3%]）; 2例（14%）尿结石患者（尿WBC中位数为0.01 [1%]和0.05 [5%]）。其他特征包括尿血吸虫病中存在卵和活化的巨噬细胞和巨细胞，急性肾小球肾炎中单核细胞和染色细胞管型数量增加，尿结石中中性粒细胞数量增加。在血吸虫病中，尿白细胞分类计数与血液白细胞分类计数无关。此外，尿液中的嗜酸性粒细胞百分比始终高于血液中的嗜酸性粒细胞百分比。因此，在泌尿系血吸虫病中，嗜酸性粒细胞尿可以通过渗出、肉芽肿脱落以及尿路表面出血来解释。电镜检查证实大部分白细胞为嗜酸性粒细胞。其中一些是粘附和脱粒卵与变量miracidal损害。尿嗜酸性粒细胞和虫卵计数彼此不相关。用汉塞尔染色法对尿沉渣涂片进行染色，有助于血尿的检查。大量嗜酸性粒细胞尿和少量单核细胞有助于诊断尿血吸虫病，而不是急性肾小球肾炎或尿结石。这些结果降低了嗜酸性粒细胞尿作为地方性泌尿系血吸虫病地区药物性间质性肾炎确证证据的价值。
Urine deposit smears of 58 patients with urinary schistosomiasis, 20 with acute glomerulonephritis, and 14 with urinary stones were stained wiht Hansel''s stain. Eosinoiphiluria was seen in all cases of urinary schistosomiasis (median 0.73 [73%] of urinary white blood cells [WBCs]); 13 (65%) of those with acute glomerulonephritis (median 0.03 [3%) of urinary WBcs); and 2 (14%) patients with uriunary stones (0.01 [1%] and 0.05 [5%] of urinary WBCs). Other features included the presence of ova and activated macrophages and giant cells in urinary schistosomiasis, and increased number of mononuclear cells and stained cellular casts in acute glomerulonephritis, and an increased number of neutrophils in urinary stones. In schistosomiasis, urine differential leukocyte counts were unrelated to those of the blood. Moreover, urine eosinophil percentages were always higher than those in the blood. Thus, in urinary schistosomiasis, eosinophiluria could be explained by exudation, sloughing of granulomata as well as bleeding from the urinary tract surface. Electron microscopic examination confirmed that most of the leukocytes were eosinophils. Some of these were adherent and degranulating over ova with variable miracidial damage. Urine eosinophil and egg counts were not correlated to each other. Staining urine deposits smears, with the use of Hansel''s stain, is useful in the investigation of hematuria. Heavy eosinophiluria and few mononuclear cells favor the diagnosis of urinary schistosomiasis rather than acute glomerulonephritis or urinary stones. These results diminish the value of eosinophiluria as corroborative evidence of drug-induced interstitial nephritis in areas of endemic urinary schistosomiasis.