Pediatric Nephrology

, Volume 9, Issue 4, pp 435–437 | Cite as

Validity of G1-cells in the differentiation between glomerular and non-glomerular haematuria in children

  • Bernhard Lettgen
  • Annette Wohlmuth
Original Article


Urine samples from 100 children and adolescents with micro-or macrohaematuria were investigated using phase contrast microscopy to establish the percentage of G1-cells that could differentiate glomerular from non-glomerular haematuria. The G1-cell is a special form of dysmorphic erythrocyte which seems to be specific for glomerular haematuria. Glomerular haematuria, defined by clinical criteria from biopsy, physical examination, standard laboratory evaluation and family history, was observed in 51 patients (group 1). Non-glomerular haematuria was found in 49 patients (group 2). The latter group had urinary tract infections, urolithiasis, hypercalciuria or haematuria caused by urological operation or diagnostic procedure. The percentage of dysmorphic erythrocytes differed significantly between the two groups studied (42±3% in group 1 vs. 6±1% in group 2, mean±SEM,P<0.01); there was also a significant difference in G1-cells (19.4±1.7% in group 1 vs. 0.6±0.2% in group 2, mean±SEMP<0.01). When glomerular haematuria was defined on the basis of ≥30% dysmorphic erythrocytes by phase contrast microscopy, sensitivity, specificity and efficiency were 71%, 100% and 85%, respectively. When glomerular haematuria was defined on the basis of ≥5% G1-cells, sensitivity, specificity and efficiency were 100%, 100% and 100%, respectively. The differentiation of glomerular and non-glomerular haematuria in children by determination of G1-cells appears to be more sensitive and efficient than the determination of the percentage of dysmorphic erythrocytes by phase contrast microscopy.

Key words

Haematuria Phase contrast microscopy Dysmorphic erythrocytes G1-cells 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Vehaskari VM, Rapola J, Koskimies O, Savilathi E, Vilska J, Hallman N (1979) Microscopic hematuria in school children: epidemiology and clinicopathologic evaluation. J Pediatr 95: 676–684Google Scholar
  2. 2.
    Sayer J, McCarthy MP, Schmidt JD (1990) Identification and significance of dysmorphic vs isomorphic hematuria. J Urol 143: 545–548Google Scholar
  3. 3.
    Birch DF, Fairley KF (1979) Hematuria: glomerular or non-glomerular? Lancet II: 845–846Google Scholar
  4. 4.
    Birch DF, Fairley KF (1980) Red cells in the urine. Lancet I: 424Google Scholar
  5. 5.
    Birch DF, Fairley KF, Whitworh JA, Forbes IK, Fairley JK, Cheshire GR, Ryan GB (1983) Urinary morphology in the diagnosis of glomerular hematuria. Clin Nephrol 20: 78–84Google Scholar
  6. 6.
    Stapleton FB (1987) Morphology of urinary red blood cells: a simple guide in localising the site of hematuria. Pediatr Clin North Am 34: 561–569Google Scholar
  7. 7.
    Pillsworth TJ, Haver VM, Abrass CK, Delaney CJ (1987) Differentiation of renal from non-renal hematuria by microscopic examination of erythrocytes in urine. Clin Chem 33: 1791–1995Google Scholar
  8. 8.
    Hildebrandt F, Fecht A, König B, Brandis M (1988) Exakte Beschreibung nicht-glomerulärer und glomerulärer Erythrozytenformen bei kindlicher Hämaturie. Monatsschr Kinderheilkd 136: 10–16Google Scholar
  9. 9.
    Fassett RG, Horgan B, Matthew TH (1982) Detection of glomerular bleeding by phase contrast microscopy. Lancet I: 1432–1434Google Scholar
  10. 10.
    Fairley KF, Birch DF (1982) Hematuria: a simple method for identifying glomerular bleeding. Kidney Int 21: 105–108Google Scholar
  11. 11.
    Offringa M, Benbassat J (1992) The value of urinary red cell shape in the diagnosis of glomerular and post-glomerular haematuria. A meta-analysis. Postgrad Med J 68: 648–654Google Scholar
  12. 12.
    Tomita M, Kitamoto Y, Nakayama M, Sato T (1992) A new morphological classification of urinary erythrocytes for differential diagnosis of glomerular hematuria. Clin Nephrol 37: 84–89Google Scholar
  13. 13.
    Fassett RG, Horgan B, Gove D, Mathew TH (1983) Scanning electron microscopy of glomerular and non glomerular red blood cells. Clin Nephrol 20: 11–16Google Scholar
  14. 14.
    Chu YD, Kitamoto Y, Tomita M, Nakayama M, Sato T (1990) Differentiation of hematuria by differential interference microscopy with a simple criterion. Kumamoto Med J 42: 63–71Google Scholar
  15. 15.
    Hauglustaine D, Bollens W, Michielsen P (1982) Detection of glomerular bleeding using a simple staining method for light microscopy (letter). Lancet II: 761Google Scholar
  16. 16.
    Raman GV, Pead L, Lee HA, Maskell R (1986) A blind controlled trial of phase-contrast microscopy by two observers for evaluating the source of hematuria. Nephron 44: 304–308Google Scholar
  17. 17.
    Crompton CH, Ward PB, Hewitt IK (1993) The use of urinary red cell morphology to determine the source of hematuria in children. Clin Nephrol 39: 44–49Google Scholar
  18. 18.
    Rizzoni G, Braggion F, Zacchello G (1983) Evaluation of glomerular and non-glomerular hematuria by phase-contrast microscopy. J Pediatr 103: 370–374Google Scholar
  19. 19.
    Pollock C, Pei-Ling L, Györy KZ, Grigg R, Gallery EDM, Caterson R, Ibels L, Nahony J, Waugh D (1989) Dysmorphism of urinary red blood cells. Value in diagnosis. Kidney Int 36: 1045–1049Google Scholar
  20. 20.
    Shichiri M, Nishio Y, Oowada A, Tomita K, Shiigai T (1986) Use of autoanalyser to examine urinary-red-cell morphology in the diagnosis of glomerular hematuria. Lancet II: 781–782Google Scholar
  21. 21.
    Lettgen B, Hestermann C, Rascher W (1994) Differentiation of glomerular and non-glomerular hematuria in children by measurement of mean corpuscular volume of urinary red cells using a semi-automated cell counter. Acta Paediatr 83: 946–949Google Scholar
  22. 22.
    Kitamoto Y, Tomita M, Akamine M, Inoue T, Itoh J, Takamori H, Sato T (1993) Differentiation of hematuria using a uniquely shaped red cell. Nephron 64: 32–36Google Scholar
  23. 23.
    Köhler H, Wandel E, Brunck B (1991) Acanthocyturia — a characteristic marker for glomerular bleeding. Kidney Int 40: 115–120Google Scholar
  24. 24.
    Kitamoto Y, Yide C, Tomita M, Sato T (1992) The mechanism of glomerular dysmorphic red cell formation in the kidney. Tohoku J Exp Med 167: 93–105Google Scholar

Copyright information

© IPNA 1995

Authors and Affiliations

  • Bernhard Lettgen
    • 1
  • Annette Wohlmuth
    • 1
  1. 1.Department of PaediatricsUniversity of EssenEssenGermany

Personalised recommendations