移植後ウィルス性出血性膀胱炎の診断と 予後改善への尿沈渣検査の活用

摘要

Urinalysis is widely used all over the world. Urine dipstick test and urinary sediment examination are simple and classic tests, and they contain unrecognized important information. For example, detect of virus infected cells or crystals in urinary sediments is not fully reported. After allogeneic hematopoietic stem cell transplantation （HSCT）, hemorrhagic cystitis （HC） may occur due to the use of immunosuppressive drugs and high-dose anticancer drugs. We detected the pathogenic components, hematoidin crystals and virus-infected cells in the urinary sediment of patients with HC after HSCT Hematoidine crystals are rare components besides hemorrhage in urinary tract, and the clinical significance of their appearance in urine has not been established, but two cases suggests that they may be useful in predicting the prognosis of HC after HSCT Virus-infected cells were found in the urinary sediment prior to hematuria in HC after HSCT suggesting that virus-infected cells may appear in urine from the early stages of HC. HC after HSCT is a fatal complication in severe cases and requires early detection and appropriate treatment. Screening for hematoidin crystals and virus-infected cells by urinary sediment examination may contribute to early diagnosis of HC and understanding of pathological conditions. [Case Report]