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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 ... #clinical #urine
Granular & “Muddy Brown” Casts on Urine Microscopy
A. Finely granular cast B. slightly coarser granular cast
Granular & “Muddy ... Urine Microscopy ... “urine poker quads ... coarse (c) and muddy ... #Urine #Microscopy
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 ... #Urine #Microscopy
Muddy Brown Casts in ATN
#Clinical #Path #Nephro #Urine #Microscopy #MuddyBrownCasts #ATN
Muddy Brown Casts ... #Path #Nephro #Urine
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... Casts • Hyaline ... • "Muddy Brown ... suggestive of nephrotic sydnrome ... #Urine #Microscopy
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
Hematuria - Differential Diagnosis Framework

Gross Hematuria: Red/Dark urine
 • 1ml blood/liter urine can induce color change
Hematuria: Red/Dark urine ... 1ml blood/liter urine ... disease - Alport syndrome ... pain hematuria syndrome ... • Nutcracker syndrome
Urinary Casts and Disease Associations
Hyaline - May be nonspecific; seen in normal individuals or during severe
Urinary Casts and ... and concentrated urine ... "Muddy-brown" heme-granular ... casts are seen ... Fatty - Nephrotic syndrome
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 ... dysmorphic RBCs in urine ... Nephritic #Nephrotic #Syndrome
Causes Abnormal Urine Color - Differential Diagnosis
Turbid White Urine (Albinuria):
 • Chyluria, Filariasis, Schistosomiasis, Malignancy, Phosphaturia,
Causes Abnormal ... • Drummond's syndrome ... (blue diaper syndrome ... Bag Syndrome - ... UTI caused by (Proteus