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INTRODUCTION
HANSEL® Stain, one-minute technic, is formulated for use as an aid in differentiating eosinophils and neutrophils using a quick, inexpensive, clinical microscopic procedure. HANSEL Stain is adaptable for various secretions such as nasal, urine, sinus, aural, conjunctival, salivary, bronchial and gastrointestinal.
>Determining the cytologic picture through the examination of the nasal secretions can differentiate an allergic condition (eosinophil infiltration) from a bacterial infection (neutrophil infiltration).
>Determining elevated levels of eosinophils in urine (eosinophiluria) can aid in the diagnosis of many associated conditions.
When cytologic specimens are stained with the HANSEL Stain formulation and magnified, eosinophils and eosinophil granules appear red and neutrophils and mucous secretions appear blue. The result is a contrasting, colorimetric procedure for cytologic evaluation. A noninvasive secretion examination can be an easy, first diagnostic step, especially in children.
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BACKGROUND INFORMATION
Leukocytes are the major cellular components of inflammatory and immune responses and include neutrophils, eosinophils, T and B lymphocytes, monocytes, and basophils. All these cells have a specific function from antibody production to the destruction of bacteria. Neutrophils are classically thought to be critical to host defense against bacteria. Although eosinophils have similar morphology and cellular actions as neutrophils, they do not appear to have an important role during bacterial infections. However, eosinophils are produced and play a central role in host defense for conditions such as allergic reactions, bronchial asthma, helminthic infections, and other disease states. In many cases, cytological examination of secretions can be a useful aid in establishing a diagnosis of an allergy, infection or other condition.
In allergy, the pathologic picture has traditionally been characterized by eosinophilic and basophilic infiltration and edema. For example, nasal secretions of patients with allergic rhinitis are often rich in eosinophils. The degree of secretion eosinophilia is proportional to the severity of the symptoms and reactions. In milder cases of nasal allergy, eosinophils are present in comparatively small number, while in hay fever, large masses of cells may be demonstrated.
By contrast, most acute, subacute and chronic infections have been characterized by neutrophilic infiltration, consequently neutrophils are found to predominate in secretions. For instance, in the resolution stage of the common cold, neutrophils are present in large numbers and eosinophils are only scattered.
Infections frequently complicate the allergic picture and acute or subacute infections should be recognized and treated as such. Subacute bronchial infections may occur with asthma, and subacute maxillary sinusitis in allergy may require antibiotic treatment. If an infection complicates allergy of the respiratory tract, the eosinophils completely disappear from the secretions during the infectious stage but return after the infection is resolved. If resolution is delayed or does not occur the neutrophils persist.
Determining the presence of elevated eosinophil levels in urine can aid in the diagnosis of other conditions. Eosinophiluria has been found with drug induced acute interstitial nephritis (AIN), eosinophilic cystitis, atheroembolic renal disease and schistosomiasis. Urinary eosinophilia has been associated with glomerulonephritis, acute prostatitis and acute cystitis as well as rejection of renal allografts. HANSEL Stain has proven to be highly superior for the identification of urinary sediment eosinophils, and the predictive value of eosinophiluria. While other stains are inhibited with a pH of less than 7.0, HANSEL Stain has been shown to be highly sensitive. In fact, Hansel Stain is the only stain cited for detecting eosinophils in urine according to the Laboratory Test Handbook , 3rd Edition 1994, and the Medical Laboratory Observer, May 2002.
The Cytologic Picture
Determining the cytologic picture through the examination of the secretions can aid in the diagnosis so that prompt treatment can be initiated. The differentiation of an allergy from an infection may reduce the use of unnecessary antibiotics. A noninvasive secretion examination can be an easy, first diagnostic step, especially in children.
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