Maltese Cross Sign Fatty Casts

A routine urinalysis demonstrates proteinuria and fatty casts.
Maltese cross sign fatty casts. Average 5 0 of 7 ratings. Hypoalbuminemia hyperlipidemia and lipiduria. Based on these findings the physician decided to proceed with a kidney biopsy. Rbc casts in the urine.
This formation is indicated by the white arrow in the bottom image. Fatty casts oval fat bodies maltese cross pattern under polarized light. Fatty degeneration of the tubular epithelium in degenerative tubular disease. John now the.
The appearance of the maltese crosses is due to the birefringence of lipid droplets which consist mainly of cholesterol esters. Although chiefly associated with the knights hospitaller order of st. Fatty casts oval fat bodies nephrotic syndrome. They are pathognomonic for high urinary protein nephrotic syndrome.
Fatty casts containing cholesterol will produce classic maltese cross formations under polarized light. The maltese cross is a cross symbol consisting of four v or arrowhead shaped concave quadrilaterals converging at a central vertex at right angles two tips pointing outward symmetrically. Fatty casts are characteristic of degenerative tubular disease and are frequently associated with heavy proteinuria. Fatty casts with maltese cross sign.
Dm crush injuries nephrotic syndrome tubular necrosis. Round particles producing birefringent maltese crosses under polarized light are commonly seen in the urinary sediment of patients with a nephrotic syndrome. Nephrotic syndrome maltese cross sign. Formed by the breakdown of lipid rich epithelial cells these are hyaline casts with fat globule inclusions yellowish tan in color.
Fatty casts with maltese cross sign. If cholesterol or cholesterol esters are present they are associated with the maltese cross sign under polarized light. It is a heraldic cross variant which developed from earlier forms of eight pointed crosses in the 16th century.