Re: Recipe of Sternheimer stain

From:RSRICHMOND@aol.com

Claudio Ghimenton at the Azienda Ospedaliera Istituti Ospitalieri di Verona 
(in Italy) asks:

>>I am searching for the recipe of supravital Sternheimer-Malbin stain. I 
have seen some pictures of urothelial cells, and they look great!<<

Geezer time! Boy, does this query take me back!

I learned about this technique for demonstrating "glitter cells" in acute 
upper urinary tract infection (acute pyelonephritis) when I was a sophomore 
medical student (at Washington University in St. Louis, Missouri) in 1961. I 
have never seen it in use again, but it was terribly fashionable a long time 
ago.

Urine must be absolutely fresh. "Glitter cells" are neutrophils, swollen in a 
hypotonic urine, whose neutrophilic granules demonstrate rapid brownian 
movement against motionless nuclei. 

I don't have a copy of the original article, but the formula as quoted in 
Todd-Sanford (18th ed., 1991) calls for

SOLUTION 1
crystal violet 3 g
ammonium oxalate 0.8 g
95% ethanol  20 mL
distilled water 80 mL

SOLUTION 2:
safranin O  1 g
95% ethanol 40 mL
distilled water 400 mL

Mix, then filter, 3 parts of solution 1 and 97 parts of solution 2. The 
mixture keeps for three months, filtering every two weeks (the stock 
solutions keep indefinitely). 
To use, add one or two drops of stain to 1 mL of urine sediment suspension, 
and examine under the microscope, preferably with an oil immersion lens.
Commercial preparations of the stain have been available in the past.

Sternheimer R and Malbin B. Clinical recognition of pyelonephritis with a new 
stain for urinary sediments. American Journal of Medicine 1951:11;312.

Sternheimer R. A supravital cytodiagnostic stain for urinary sediments. JAMA 
1975:231;8.

Bob Richmond
Samurai Pathologist (and occasional uromancer)
Knoxville, Tennessee USA



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