To determine if microscopic urinalysis is needed in all pediatric emergency room patients screened for urinary tract infections (UTI), we compared the dipstick urinalysis and complete urinalysis (dipstick and microscopy) with urine cultures in 236 children, aged 3 weeks to 21 years. The ability to detect UTI by dipstick only and by complete urinalysis was the same, however microscopic evaluation added many false-positive results without detecting additional UTIs. Because the ability to detect UTI (sensitivity) is maintained, we now offer a dipstick only urinalysis to our emergency room for children 2 years of age or older, with a microscopic analysis performed automatically if dipstick results are positive. If no microscopic urinalysis is required, testing turn-around time is reduced by 12.3 min/test and the hospital charge is reduced from U.S. $32 to U.S. $12.

Simultaneously measuring major and minor hemoglobin (Hb) variants by capillary isoelective focusing, we obtained HbA 2 intervals in healthy volunteers (n = 412) (reference value) and patients with HbS or ({-thalassemia. We classified normal HbA 2 reference intervals into three age groups: 5 months or younger (1.2% ± 1.5%), 6 months to 1 year (2.2% ± 0.9%), and 1 year or older (2.4% ± 0.9%). These intervals were comparable to those used with other methods. Patients 1 year of age or older with HbS had significantly higher HbA 2 levels (sickle cell trait, 2.9% ± 0.9%; sickle cell anemia, 2.8% ± 1.0%; P<.05). Although reference HbA 2 intervals overlapped those in patients with HbS, no overlap in HbA 2 levels was noted between these groups and patients with ^-thalassemia (observed range, 4.3% to 7.5%). The higher than normal HbA 2 interval in patients with HbS must be considered before a diagnosis of sickle cell trait or sickle cell disease with fi-thalassemia is made. (Key words: Capillary isoelectric focusing; Hemoglobin A 2 ; Hemoglobin S; Reference intervals; PThalassemia) Am J Clin Pathol 1997;107:88-91.