Appearance of hemosiderin in centrifuged specimen on routine urinalysis:
(1) coarse brown granules in renal tubular epithelial cells
(2) coarse brown granules in cellular casts
(3) free coarse brown granules
Confirmation as hemosiderin: iron stain (granules blue on Prussian blue stain)
Occurrence of hemosiderinuria
(1) intravascular hemolysis
(2) paroxysmal nocturnal hemoglobinuria
(3) multiple transfusions (reflecting hemolytic anemia or delayed transfusion reactions)
(4) hemochromatosis (as part of the generalized iron deposition)
(5) myoglobinuria
The patient may or may not have a history of hemoglobinuria or passing red-colored urine.
Reasons the test may be requested:
(1) detect low grade hemoglobinuria
(2) confirm recent hemolytic episode
(3) presence of unexplained anemia
(4) confirm findings seen on examination of the urine sediment
