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., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
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].