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Test ID: Hemosiderin
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Hemosiderin in Urine and in Bronchial Wash/Lavage
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Useful For
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Detecting hemosiderinuria ( iron in urine), secondary to excess hemolysis, as in incompatible blood transfusions, severe acute hemolytic anemia or hemochromatosis and for detection of siderophage in bronchial Wash/Lavage.
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Method name and description
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Cytochemical method (Prussian blue reaction) using a commercial Iron Stain Kit.
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Reporting name
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Hemosiderin Urine
Hemosiderin Bronchial Wash/Lavage.
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Clinical information
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When blood leaves a ruptured blood vessel, hemoglobin is released into the extracellular space. Phagocytic cells (macrophages) engulf (phagocytose) the hemoglobin to degrade it, producing hemosiderin. When urinary hemoglobin is reabsorbed by renal tubular cells, it is processed to hemosiderin. Hemosiderin is detected in iron-stained urinary sediment in sloughed renal epithelial cells. Therefore, urine hemosiderin may suggest severe or intravascular hemolysis. The presence of hemosiderin-laden alveolar macrophages in bronchoalveolar lavage (BAL) fluid is a useful for diagnosis of some pulmonary disease such as diffuse pulmonary hemorrhage syndromes and diffuse interstitial pulmonary diseases (DIPD) .Hemosiderin is seen microscopically as blue granules deposited extracellularly or in the epithelial cells and occasionally in casts in an acidic or neutral urine and in macrophages in case of BAL
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Specimen type / Specimen volume / Specimen container
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Urine / BAL
Container/Tube: Sterile plastic urine container without any preservative
Specimen Volume: Preferably 5.0ml.
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Collection instructions / Special Precautions / Timing of collection
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Collect a random urine specimen (preferably first morning midstream collection.
BAL Specimen can be collected anytime.
Slides should be prepared as soon as possible once the sample received in the laboratory.
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Relevant clinical information to be provided
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History of acute hemolysis, Pulmonary disease
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Storage and transport instructions
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Ambient (Processing should be done, preferably within 1-2 hrs after collection)
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Specimen Rejection Criteria
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- Broken/leaking specimen.
- Inadequate patient identifiers on specimen.
- Unlabeled specimen.
- Discrepancy between patient specimen and requisition information.
- Improper collection/container.
- Delayed (old) specimen
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Biological reference intervals and clinical decision values
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Test is assessed qualitatively as present or absent depending on the blue staining granules spotted.
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Factors affecting test performance and result interpretation
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If urine specimen is received after 2 hours of collection and BAL specimen is received after 4 hours of collection, cells might disintegrate and affect result interpretation.
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Turnaround time / Days and times test performed / Specimen retention time
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1 Working day
Test is performed daily
Specimen is retained for 3 Days at 2 - 8 °C
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