Leukocyturia

Description:

Leukocyturia - allocation of leukocytes with urine in the quantity exceeding norm. By norm consider detection single in sight of leukocytes (0-2 at men and to 5 - 6 at women) at approximate studying of an uric deposit (microscopy with increase by 40 times) and no more than 4-10 in 1 ml to urine at calculation in the camera.

Leukocyturia symptoms:

The considerable leukocyturia is called a pyuria. The pyuria can be suspected already at a macroscopic research on diffusion opacification of urine or on detection of the lumps and flakes which are not disappearing during the heating or addition of 10% of solution of acetic acid (that distinguishes the turbidity caused by leukocytes from the turbidity connected with presence of salts). At chronic pyelonephritis owing to a polyuria and a leukocyturia urine can take a characteristic form of chicken broth. However the leukocyturia always has to be confirmed by microscopic examination.

The urine containing a large number of leukocytes and bacteria often has alkali reaction. The resistant leukocyturia at acid reaction of urine is suspicious on tuberculosis of kidneys.

It is important to distinguish an infectious (bacterial) leukocyturia from aseptic. The interpretation of any leukocyturia as infectious can cause mistakes in diagnosis and medical tactics (unreasonable prescription of antibiotics). The pyuria is always combined with a bacteriuria, i.e. is a sign of infectious and inflammatory process in uric system, the moderate leukocyturia happens also aseptic. For example, at a subacute current and an aggravation of a .khronichesky glomerulonephritis, especially with a nephrotic syndrome, in an urocheras quite often find till 30-40 in sight of leukocytes without bacteriuria (repeatedly negative takes of crops).

In differentiation of these two types of a leukocyturia, in addition to a bacteriological research of urine, studying of qualitative features of leukocytes - identification of so-called active leukocytes, Shterngeymer's cells - Malbina and definition of a ratio of separate types of leukocytes in the painted smears from an urocheras (an "uric" leukocytic formula) matters. The infectious leukocyturia (at pyelonephritis and other localizations of inflammatory process) differs in the high content of active leukocytes (Shterngeymer's cells - Malbina) and dominance of neutrophils (95 - 100%). Relative increase in maintenance of lymphocytes (20%), sometimes eosinophils (atopic forms of nephrite, medicinal intersticial nephrite) is characteristic of an abacterial leukocyturia (lupoid nephrite, a chronic glomerulonephritis).

In addition to specification of genesis of a leukocyturia, carry out topical diagnosis, i.e. establish the level of emergence of a leukocyturia in uric system. Simultaneous stay in an urocheras of leukocytic and granular cylinders testifies to an origin of leukocytes from kidneys. Topical diagnosis of a leukocyturia is promoted by conducting trekhstakanny test, a tsistoskopiya, catheterization of ureters.

Leukocyturia reasons:

Normal in a one-time portion of urine quantity of leukocytes under review at men to 5-7, at women till 7-10 (M. V. Ehrman).

As the found leukocytes allocate different types уроцитограмм:

    * neutrophylic — an infection: pyelonephritis, tuberculosis
    * mononuclear — a glomerulonephritis, intersticial nephrite
    * lymphocytic — a system lupus erythematosus, a pseudorheumatism (system option)
    * eosinophilic — an allergosis

By quantity of the allocated leukocytes it is possible to divide into a microleukocyturia (less than 200 in пзр) and a pyuria (more than 200 in пзр).

Leukocyturia level:

    * renal (tubular and glomerular) — at a glomerulonephritis, intersticial nephrite
    * renal (cups, a pelvis) — at pyelonephritis, tuberculosis, a kidney anthrax, anomalies of position of kidneys, a hypoplasia, a polycystosis of kidneys, a hydronephrosis.
    * extrarenal (ureters) — doubling of ureters, an ureter diverticulum, a megaloureter, an ectopia of an ureter, PMR, an ureter excess.
    * extrarenal (bladder) — a bladder diverticulum, cystitis, bladder stones, to the ureterotsela, tuberculosis
    * extrarenal (urethra) — an urethra stricture, the urethra valve, an urinary fistula, an urethritis, a phymosis

Clinical character of a leukocyturia:

    * Abacterial — intersticial process in renal fabric
    * Bacterial — an infection, tuberculosis

Treatment of the Leukocyturia:

Carry out treatment of a basic disease.