Hello:
I recall two similar cases during the past few years. On each occassion
we involved a forensic laboratory to make a definitive analysis of the
urine specimen (testing for acid phosphatase, then acid
phosphatase-histochemical staining of a slide, and finally Y chromosome
DNA by PCR) to rule in or rule out the "sperm" observed (but not formally
reported) by our staff. We contacted the physicians to let them know that
we were conducting diffinitive tests before making a formal report. In
each case, the final result was negative and there was no supporting
evidence of sperm in the specimen.
I have no idea what the initial observation was, (yeast, bacteria, cells
etc) however it was not an isolated spermatocyte.
This subject matter is difficult for a pediatric hospital. You do
not dare ignore the observations, yet it is very difficult to pursue
diffinitive tests, examinations etc. without mentioning details to the
parents...... In addition, forensic labs are reluctant to take on any
testing unless the specimens are connected to a formal police
investigation.
I support the notion of performing definitive tests before making a
formal report. I think it is important to let the physician know what is
going on....and if this lab report comes as a complete shock to the
physician, then I would implore them not to disclose your (likely false)
suspicions to the family. If the definitive tests are positive, it would
be the physician's responsibility to initiate an investigation.
These cases have considerable impact on the technical staff. Our
first line a investigation was to have an anatomic pathologist "verify"
the observation. Unfortunatley, they seldom look at cells in urine and so
far they have not been confident in ruling in or ruling out the
observations made by our technical staff.
Those are my thoughts on this matter. regards, Andrew
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Andrew Lyon, Clinical Biochemist email: [log in to unmask]
Saskatoon, SASK, CANADA. homepage: http://duke.usask.ca/~lyona
On Mon, 27 Sep 1999, Lepage, Nathalie wrote:
> Hello to all,
>
> I came across a rather rare event and I would appreciate to have some
> feed-backs.
>
> We analysed a female urine sample in which we found sperm. Somebody
> challenged the finding and argued that he heard of possible artefact that
> could mimic sperm. According to this person, an agglomerate of skin cells,
> bacteria and yeast can be misleading and can resemble sperm enough, leading
> technologists to report presence of sperm in a urine sample.
>
> Does anyone have knowledge about this artefact. Any reference, and
> especially any picture to illustrate this rather unexpected finding would be
> appreciated.
>
> Thank you,
>
> Nathalie Lepage, Ph.D., FCACB, CSPQ
> Clinical Biochemist
> Children's Hospital of Eastern Ontario
>
>
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