Dysmorphic Erythrocytes Significance in Urinalysis
Dysmorphic erythrocytes, or red blood cells (RBCs) with abnormal shapes, are observed during urine analysis. Their presence is a specific indicator related to the origin of bleeding within the urinary tract.
Nephritis and Glomerular Bleeding
The characteristic shape changes in dysmorphic erythrocytes often result from their passage through damaged glomerular capillaries in the kidney. This damage compromises the filtration barrier, leading to:
- Altered RBC morphology (e.g., budding, acanthocytic forms).
- Entry of RBCs into the urine filtrate.
Therefore, the presence of significant numbers of dysmorphic erythrocytes in urine strongly suggests glomerular disease, such as Nephritis.
Differential Diagnosis
While other conditions can cause blood in the urine (hematuria), they typically feature normally shaped RBCs:
- Pyelonephritis and Renal tract infection: Primarily infections causing inflammation. Hematuria, if present, usually contains normal RBCs unless glomerular involvement occurs secondary to severe infection.
- Renal stone disease: Bleeding is often due to physical trauma from the stone. RBCs are typically normal in shape.
Nephritis, specifically involving the glomeruli, is the condition most directly indicated by the presence of dysmorphic erythrocytes.
Conclusion
Finding dysmorphic erythrocytes in a urine sample is a key sign pointing towards a kidney issue originating in the glomeruli, making Nephritis the most suggestive diagnosis among the given options.
Important Questions from Nephrotic Syndrome
- All of the following conditions are associated with Glomerulonephritis with low complement level, EXCEPT:
- A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history of sore throat two weeks prior to presentation. Laboratory investigations are remarkable for low $C_3$ and increased titres of ASO and antiDNase. Which one of the following statements is NOT correct about management for this condition?
- Which of the following are the indications of Renal biopsy?
1. Chronic Kidney disease with normal sized kidney
2. Nephrotic syndrome in adults
3. Nephrotic syndrome in children with atypical features
Select the correct answer using the code given below: A 40-year-old female with nephritic range proteinuria is found to have low serum complement levels. Which of the following can be the likely etiology?
1. Systemic lupus erythematosus
2. Post-infectious glomerulonephritis
3. Infective endocarditis
4. Mesangio-capillary glomerulonephritis
Select the correct answer using the code given below:
- Which of the following are consequences of nephrotic syndrome ?
1. Increased lipoprotein synthesis
2. Low serum globulin levels
3. Increased serum aldosterone levels
4. Increased serum Antithrombin III levels
Select the correct answer using the code given below :
