GLOMERULONEPHRITIS-CASTS

SUMMARY

1. Casts always originate in the tubules.

2. Red cell casts are seen only in glomerulonephritis.

3. White cell casts are typically seen in pyelonephritis or AIN.

4. Granular casts can be nonspecific; in the setting of AKI they are characteristic of ATN.

5. In patients with significant proteinuria, free fat can assemble into a cast (called a fatty cast) or oval fat bodies, characterized by "Maltese crosses" under polarized light.

6. Hyaline casts do not indicate disease and are seen with concentrated urine.

Reference(s)

Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].