Urinalysis Case Study - What is Eosinophiluria

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What is Eosinophiluria?

Eosinophiluria is a condition that is characterized by the presence of eosinophils in urine. During routine urinalysis testing, eosinophiluria may be discovered if the urine dipstick (macroscopic exam) yields a negative result for leukocyte esterase, but many granular- appearing WBCs are seen during the sediment testing (microscopic exam). To verify the presence of eosinophils, the sample should be concentrated and stained with Wright or Wright-Giemsa stain to identify the red-orange granules typical of the cells. In cases where a positive identification cannot be made due to inadequate staining of the sample, Hansel stain may be used and, in some cases, may be considered superior to traditional peripheral blood stains.

Conditions associated with eosinophiluria include acute interstitial nephritis, acute prostatitis, progressive glomerulonephritis and urinary tract infection or obstruction, among others. Because many of these pathologies are connected to or may lead to kidney damage, laboratories should be aware of the significance of urine eosinophils, even if they are not performing this testing on site.

Morphology/Features:

• Round to oval WBCs that appear larger than neutrophils
• Heavy, coarse intracellular granulation
• Identification should be verified using appropriate stains
  
  

Resources:
Corwin HL, Bray RA, Haber MH. The detection and interpretation of urinary eosinophils. Arch Pathol Lab Med. 1989 Nov;113(11):1256-8. PMID: 2479358.
Nolan CR 3rd, Kelleher SP. Eosinophiluria. Clin Lab Med. 1988 Sep;8(3):555-65. PMID: 2458885.
Color Atlas of the Urinary Sediment, College of American Pathologists, Northfield, IL.

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