ABSTRACT
Hematuria is a important clinical sign that is a consequence of significant fenal. urologic or sytemic disease. Recently the morphology of the red cell in hematuria has been used to indicate a renal or non-renal source and also the measurement of red cell volume by red cell analyzer has been used to distinguish glomerular from non-glomerular hematuria. In this study. the MCV(mean corpsular red cell voume). RDW(red cell distribution width) and HDW (hemoglobin distribution width) were measured using H-1 system in57 children with hematuria to assess the diagnostic usefulness of the urinary red cell analyzer in the differentation of glomerular and non-glomerular hematuria. The patients were divided into two groups as glomerular diseases(40cases)and non-glomerular diseases(17 cases)and the location of the bleeding was confirmed by renal biopsy, radiology and the clinical findings. The results were as follows. 1) The urinary red cell MCV waslower in patients with glomerular diseases than that in patients with non-glomerular diseases (79.89 +/- 12.0fl vs. 90.93 +/- 9.71fl vs. 90.93+/-9.71 fL; p<0.01) 2) The urinary RDW and HDW were significantly higher in glomerular diseases than those in non-glomerular diseases (RDW; 19.86 +/- 11.28% vs 11.34+/-5.88%, HDW; 3.37+/-2.07 gm vs. 1.86+/-1.43gm). 3) The urinary red cell MCV was correlated well with the RDW and HDW while there was no correlation between the urinary red cell MCV and the urinary SG or pH. 4) The sensitivity, specificity and positive predictability of the urinsary MCV were 37.8%, 94.1% and 93.7% and those of RDW were 62.5%, 82.3% and 89.2% 5) The sensitivity, specificity and positive predictability of the urinary HDW were 42.5%, 88.2% and 89.4% We concluded from above date that the measurment of the urinary MCV, RDW and HDW would be useful as a primary non-invasive screening test in differentation of glomerular and non-glomerular hematuria in children.
Subject(s)
Child , Humans , Biopsy , Cell Size , Diagnosis , Hematuria , Hemorrhage , Hydrogen-Ion Concentration , Mass Screening , Sensitivity and SpecificityABSTRACT
Hemophagocytic syndrome has been identified as a benign reactive histocytic proliferation with marked hemophagocytosis and usually associated with systemic viral infection. Recently similar cases that were associated with bacteria have been described. The syndrome is clinically characterized by fever, severe constitutional symptoms, hepatosplenomegaly, lymphadenopathy and laboratory findings of pancytopenia, hemophagocytosis, abnormal liver function test and coagulopathy. The authors experienced a case of bacteria associated hemophagocytic syndrome in a 11-year old girl following Mycoplasma pneumoniae infection. The patient showed characteristic clinical features of hemophagocytic syndrome, peripheral pancytopenia and phagocytized histiocytes in bone marrow. The brief review of the literature was made.