TITLE: Eosinophil Smear: Nasal Specimen and/or Urine Specimen

PRINCIPLE

Eosinophilia may be noted in allergic diseases such as bronchial asthma, hay fever, angioneurotic edema, urticaria and erythema multiforms. The eosinophilia can be found in the peripheral blood, bone marrow, sputum (bronchial asthma), nasal and conjunctival discharges (hay fever) and urticarial skin lesions and vesicles. Mild to moderate blood eosinophilia is usually found. It has yet to be determined what the exact role of eosinophilia in the allergic immunologic reaction is. Eosinophils may be chemotactically attracted by antigen – antibody complexes or histamine that is involved in such reactions.

PERSONNEL

Medical Technologists and Technicians

SPECIMEN

Patient Preparation: No special patient preparation necessary.

Type of Specimen: Smears made from nasal discharge or the nasopharyngeal cavity; smears

made from fresh urine.

Handling Precautions: Gently roll swab from affected area onto 2 glass slides to avoid

destroying the eosinophils for the nasal specimens.

Handle all specimens using Standards Precautions.

REAGENT

Wrights stain or Wright Giemsa

Methanol

EQUIPMENT

Slide Stainer

Microscope

Cytocentrifuge

CALIBRATION

No calibration necessary

QUALITY CONTROL

Stain quality is assessed on a daily basis. See procedure 4840-HE-0572 Aerospray Hematology Pro Use and Maintenance for QC instructions.

STEPWISE PROCEDURE

Nasal Specimen

Collect the specimen by gently rotating a sterile cotton swab over the area or against the walls of the nose.

Gently roll the swab over the glass slide to transfer a thin layer of the specimen onto the glass slide. Make 2 smears.

Label the slide(s) with the date, and patient’s name.

Permit the smear(s) to dry.

Stain as you would a peripheral blood smear either through the slide stainer or fix and stain using another method.

Scan the slide(s) using a microscope.

Report eosinophils seen as none, few, moderate or many.

Urine Specimen

Obtain random urine sample.

Make two smears using a cytocentrifuge. If the urine is cloudy-use one to two drops of well-mixed urine; if the urine is clear to hazy, use two drops to 0.5 ml of the urine. If no cytospin is available, spin the urine, remove the supernatant, mix the sediment and make 2 smears from the sediment distributing material with the pipette in a circular motion in the middle of the slide. This should be no larger than the size of a dime.

Continue with steps 3-7 as above.

REPORTING RESULTS

Report EOS seen as few, moderate, many or none seen through the LIS. Refer to the LIS Procedure Manual for complete instructions.

CALCULATIONS

None

NORMALS

No eosinophils seen

REFERENCES

Isreal Davidsohn, M.D., F.A.C.P., and John Bernard Henry, M.D. editors. Todd-Sanford Clinical Diagnosis by Laboratory Methods –14th edition, W.B. Saunders Company (Philadelphia, 1969) p. 278-279.

William R. Platt, M.D., F.C.A.P., Color Atlas and Textbook of Hematology Second Edition, J.B. Lippincott Company (Philadelphia, 1979) pp. 170 and 417.