BMJ 1994;309:409-10 (6 August)

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Microscopic haematuria Examine urinary deposite before cystoscopy

EDITOR, - The algorithm of diagnostic tests for microscopic haematuria in Fritz H Schroder's editorial is illogical.1 Once microscopic haematuria has been detected and infection excluded the next stage is to locate the site of bleeding. Practically this is either renal or urological, and the distinction can be made by light microscopy of a freshly provided centrifuged urinary deposit. Phase contrast microscopy can help distinguish dysmorphic from non-dysmorphic erythrocytes in difficult cases. The recommendation to perform cystoscopy before this simple, non-invasive, cheap, and effective procedure will condemn many patients with readily demonstrable glomerular haematuria to an unpleasant, uninformative, and unnecessary investigation. This is especially important in the younger age group, in which glomerular disease causes haematuria in a higher proportion of cases.

The detection of microscopic haematauria of glomerular origin is certainly grounds for further investigation since the commonest primary glomerulopathy-lgA nephropathy was reported ported to progress to end stage . . . [Full text of this article]


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Relevant Article

Microscopic haematuria
Fritz H Schroder
BMJ 1994 309: 70-72. [Extract] [Full Text]

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