Diagnostic Value of Dysmorphic Urinary Red Cells

To the Editor: Dr. Saad's photomicrographs of dysmorphic urinary erythrocytes (Images in Clinical Medicine, May 30 issue), 1 although beautiful, are dangerously misleading. Dysmorphic cells do not represent glomerular bleeding, as the legend implies. They can be produced as a result of kidney biopsies 2 and are therefore not necessarily of glomerular origin. Renal tumors can also be expected to produce dysmorphic hematuria. By assuming that a finding of dysmorphic red cells rules out all causes of hematuria other than glomerulonephritis, one could miss a renal tumor. Dr. Saad replies: To the Editor: Dr. Györy correctly notes that dysmorphic urinary erythrocytes may . . .