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Glitter cells (also called Sternheimer-Malbin positive cells) are polymorphonuclear leukocyte neutrophils with granules that show a Brownian movement and that are found in the urine, most commonly associated with urinary tract infections or pyelonephritis and especially prevalent under conditions of hypotonic urine (samples with specific gravity less than 1.01). [1]
Pyuria is the condition of urine containing white blood cells or pus. Defined as the presence of 6-10 or more neutrophils per high power field of unspun, voided mid-stream urine, it can be a sign of a bacterial urinary tract infection. Pyuria may be present in people with sepsis, or in older people with pneumonia.
Neutrophils are the most abundant white blood cells in the human body (approximately 10 11 are produced daily); they account for approximately 50–70% of all white blood cells (leukocytes). The stated normal range for human blood counts varies between laboratories, but a neutrophil count of 2.5–7.5 × 10 9 /L is a standard normal range.
The urine test strip test for white blood cells detects leukocyte esterase, which is present in azurophilic granules of monocytes and granulocytes (neutrophilic, eosinophilic and basophilic). Bacteria, lymphocytes and epithelial cells from the genitourinary tract do not contain esterases. [21]
Typically, most white blood cells (WBCs) in urine are neutrophils. They are round, larger than RBCs, possess a cell nucleus , and have a granular appearance. A few white blood cells can normally be found in the urine of healthy individuals; females tend to have slightly more than males.
There are four types of granulocytes (full name polymorphonuclear granulocytes): [3] Basophils; Eosinophils; Neutrophils; Mast cells; Except for the mast cells, their names are derived from their staining characteristics; for example, the most abundant granulocyte is the neutrophil granulocyte, which has neutrally staining cytoplasmic granules.
Reference ranges for urine tests are described below: Measurement Lower limit Upper limit Unit ... Leukocytes: n/a: 0 / negative [2] See also. Reference range;
Urinalysis is the most useful test to start the work up in a patient of dysuria. Urinalysis positive for nitrite carries a high predictive value of a positive urine culture. Also, urine dipstick showing leukocytes as equal predictive value as the presence of nitrites. When both are present, the predictive value goes even higher.