CLINICO-LABORATORY SIGNS PROMOTING OBJECTIVE DIAGNOSTICS OF EXACERBATION OF CHRONIC PYELONEPHRITIS

Abstract

THE AIM of the present investigation was to compare the morphological features of the urine leukocytes showing the presence of an inflammatory process with a reliable laboratory indicator of the presence of tubulo-interstitial lesion (β₂ -microglobulinuria). PATIENTS AND METHODS. The investigation was carried out in 2 groups of patients: the main group included 68 patients with the main or concomitant diagnosis of exacerbation of chronic pyelonephritis and a control group consisting of 21 healthy subjects. The investigation included the following: the content of leukocytes in peripheral blood, erythrocyte sedimentation rate, C-reactive protein, detailed analysis and cytological investigation of the urine sediment with the methylene blue staining (personal modification) for the detection of active leukocytes and determination of bacteriuria and β ₂ -microglobulinuria. RESULTS. Two kinds of leukocytes were found in the urea. The leukocytes of the first group were of usual sizes and shape, with a poorly discernible nucleus and rough granulosity in the cytoplasm. The leukocytes of the second group were characterized by larger sizes (two-three times more than normal), round shape and sometimes by vacuolized cytoplasm. P₂ -microglobulinuria was found in 57 patients, and 62 patients had bacteriuria. These two signs were not always simultaneously. In the control group the level of β ₂ -microglobulinuria in the urine varied from 0.02 to 0.09 with the average value 0.061 mg/l. CONCLUSION. In all patients having active leukocytes the level of p₂ -microglobulinuria was higher than in the control group. Permanent detection of young polysegmentonuclear, active leukocytes in acute pyelonephritis and increasing β ₂ -microglobulinuria, as compared with healthy subjects, suggest that these indices can be used as additional laboratory confirmation of the diagnosis of activity of chronic pyelonephritis.