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Granular & “Muddy Brown” Casts on Urine Microscopy A. Finely granular cast B. slightly coarser granular cast
Granular & “Muddy ... Brown” Casts on ... Finely granular cast ... coarser granular cast ... coarse (c) and muddy
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy - Casts ... Acellular Casts ... • Hyaline Casts ... • "Muddy Brown ... suggestive of nephrotic sydnrome
Muddy Brown Granular Casts three ways - Brightfield, Darkfield, Phase Contrast. Dr. Vipin Varghese @vipvargh #Muddy #Brown #Granular
Muddy Brown Granular ... Casts three ways ... Varghese @vipvargh #Muddy ... Brown #Granular #Casts
Glomerular Diseases - Nephritic and Nephrotic Syndromes Nephritic syndrome—due to GBM disruption. Hypertension. t BUN and creatinine.
and Nephrotic Syndromes ... Nephritic syndrome—due ... RBC casts in urine ... but in severe cases ... Nephritic #Nephrotic #Syndromes
Examples of varying granular and granular/waxy mixed casts: A: coarse granular/broad-waxy (and surrounding white blood cells);
granular/waxy mixed casts ... light granular/muddy ... granular, C and D: muddy ... Granular #MuddyBrown #Casts
Urinary Casts and Disease Associations Hyaline - May be nonspecific; seen in normal individuals or during severe
Urinary Casts and ... breakdown of cellular casts ... "Muddy-brown" heme-granular ... casts are seen ... Fatty - Nephrotic syndrome
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
microscopy • Red cell casts ... • White cell casts ... disease • Granular casts ... renal disease • “Muddy ... brown cast” - Necrotic
Nephritic vs Nephrotic Syndrome Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes. Step
Nephritic vs Nephrotic Syndrome ... nephrotic/nephritic syndromes ... hematuria (RBC casts ... Nephritic #Nephrotic #Syndrome
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG) SAAG ≥ 1.1: - Ascitic protein
Cirrhosis, Late Budd-Chiari ... syndrome, Massive ... pericarditis, Early Budd-Chiari ... syndrome, IVC obstruction ... leak, Nephrotic syndrome
Differentiation Between Nephrotic Syndrome and Nephritic Syndrome == Nephrotic Syndrome == Onset - Insidious Edema - ++++ Blood
Between Nephrotic Syndrome ... and Nephritic Syndrome ... == Nephrotic Syndrome ... Red blood cell casts ... Red blood cell casts
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