What is the cause of dyserythrocyte hematuria?

Abnormal red blood cells and hematuria can actually have many adverse effects on health, so it is necessary to understand the causes. Common ones include acute glomerulonephritis or chronic nephritis, as well as urinary stones, which may cause this symptom of hematuria.

Common causes of hematuria include acute glomerulonephritis, chronic nephritis, acute pyelonephritis, and urinary tract stones. Tuberculosis, tumor, trauma, etc. If there is simply a large amount of hematuria, the possibility of stones is greatest.

1. Abnormal red blood cell standards

Birech reported that abnormal red blood cells were classified into the following seven categories: red blood cells of varying sizes and abnormal shapes [6]: ① Yeast-like red blood cells: small vesicles protrude from the outer membrane of red blood cells or the cells show mold spore-like changes. ② Fried bread roll-like red blood cells: The red blood cell membrane has two obvious inner and outer circles, and is thickened all around, shaped like a fried bread roll. ③Ancient coin-like red blood cells: shaped like ancient Chinese coins. ④Membrane-defective red blood cells: The red blood cell membrane is incomplete and part of the hemoglobin (Hb) is lost. ⑤ Macrocytic cells: The cell body is enlarged, the center is pale, and there is no double disc depression. ⑥ Microcytes: small cell body, thickened outer membrane, and enhanced refraction. ⑦ Bracelet-like red blood cells: The cell body is larger and shows obvious changes in the inner and outer membranes.

2. Homogeneous red blood cell standard

The red blood cells are uniform in size and change evenly, with no more than two phases. Most are normal and mulberry-like red blood cells, and some may have ghost red blood cells. This type is mostly non-glomerular hematuria.

3. Mixed red blood cell standard

According to the different proportions of abnormal and uniform red blood cells, it can be divided into two types: mixed red blood cell hematuria with mainly abnormal red blood cells (abnormal red blood cells>50%) and mixed red blood cell hematuria with mainly uniform red blood cells (uniform red blood cells account for>50%).

4. Judgment Limits

If abnormal red blood cells account for more than 80%, it is glomerular hematuria; if abnormal red blood cells account for less than 20% and homogeneous red blood cells account for more than 80%, it is non-glomerular hematuria; if abnormal red blood cells account for more than 20% and less than 80%, it is mixed hematuria.

5. Abnormal red blood cell morphology and glomerular hematuria

There are 7 to 8 types of abnormal red blood cells with various shapes. In glomerular hematuria, the vast majority are dysmorphic red blood cells, accounting for more than 80%; in non-glomerular hematuria, the vast majority are homogeneous red blood cells, accounting for more than 80%; there are also mixed types with dysmorphic red blood cells as the main component (>50%) and mixed types with homogeneous red blood cells as the main component (>50%). The above three types of results of abnormal red blood cells, homogeneous red blood cells and mixed red blood cells are all trending and cannot be reversed. Of course, it is more objective to observe in combination with clinical symptoms.