Urine cast is a microscopic cylinder structure produced by the kidney and is present in the urine in certain disease states. They form in distal tubular tubules and collect the nephron ducts, then excrete and enter the urine, where they can be detected by microscopy.
They are formed by the deposition of Tamm-Horsfall mucoproteins secreted by renal tubular cells, and occasionally also by albumin under conditions of proteinuria. Cast formations are spoken in environments that support protein denaturation and precipitation (low flow, salt concentration, low pH). The Tamm-Horsfall protein is highly susceptible to precipitation under these conditions.
The player was first described by Henry Bence Jones (1813-1873).
As reflected in the cylindrical form, the cast is produced in small convoluted tubules and collects the renal duct, and generally retains its shape and composition as it passes through the urinary system. Although the most common form is benign, others show illness. All depend on the inclusion or adhesion of various elements on the base of the hyaline mucoprotein. "Cast" itself only describes the shape, so adjectives are added to describe the composition of the player. Various casts found in urine sediments can be classified as follows.
Video Urinary cast
Coretan Acellular
Granular scrolling
The second most common type of cast, granular casts can be produced either from cell gypsum damage or the inclusion of aggregate plasma proteins (eg, albumin) or the immunoglobulin light chain. Depending on the size of the inclusions, they can be classified as fine or coarse, although the difference has no diagnostic significance. Their appearance is generally more cigar-shaped and a higher refractive index than hyaline gypsum. While most commonly show chronic kidney disease, this cast, as with hyaline cast, can also be seen for a short time after strenuous exercise. The "muddy brown castings" seen in acute tubular necrosis are a type of granular cast.
Candle casts
Thinking to represent the final product of cast evolution, wax cast shows very low urine flow associated with severe and long-lasting kidney disease such as renal failure. In addition, because the urinary stasis and its formation in the widened and widened ducts, the cast is significantly larger than the hyaline gypsum.
- They are cylindrical.
- They have a higher refractive index.
- They are more rigid, showing sharp edges, broken bones, and dotted ends.
Wax gypsum is a wide cast, which is a more general term to describe a broader cast product than a dilated channel. This is seen in chronic renal failure.
In the nephrotic syndrome many additional cast types include wide and waxy cast if this condition is chronic (this is referred to as telescopic urine in the presence of many casts).
Fatty casts
Formed by the breakdown of lipid-rich epithelial cells, this is a hyaline cast with globule-ink, yellowish inclusions. If cholesterol or cholesterol ester is present, they are associated with a "Maltese cross" sign under polarized light. They are pathognomonic for high-protein urinary nephrotic syndrome.
Pigment cast
Formed by the adhesion of metabolic damage products or drug pigments, the cast is so named because of the color change. Pigments include those endogenously generated, such as hemoglobin in hemolytic anemia, myoglobin in rhabdomyolysis, and bilirubin in liver disease. Drug pigments, such as phenazopyridine, can also cause cast color changes.
Crystal cast
Although crystallizing urine solutes, such as oxalate, urate, or sulphonamides, may become entangled in the ketanaline grease during its formation, the clinical significance of these events is not well felt.
Maps Urinary cast
Mobile phone casts
Red blood cells
The presence of red blood cells in plaster is always pathological, and strongly suggests granulomatosis with polyangiitis, systemic lupus erythematosus, posttreptococcal glomerulonephritis or Goodpasture syndrome. They can also be associated with kidney infarction and subacute bacterial endocarditis. They are a yellowish brown color and are generally cylindrical with occasional edges; Their fragility makes checking of fresh samples necessary. They are usually associated with nephritic syndrome or urinary tract injury.
White blood cell
Indications of inflammation or infection, the presence of white blood cells in or on the plaster shows very pyelonephritis, a direct infection of the kidneys. They can also be seen in inflammatory states, such as acute allergic interstitial nephritis, nephrotic syndrome, or acute post-streptococcal glomerulonephritis. White cells can sometimes be difficult to distinguish from epithelial cells and may require special staining. Differentiation of simple white cell clumps can be done in the presence of hyaline matrices.
Gypsy bacteria
Given their appearance in pielonephritis, this should be seen in association with loose bacteria, white blood cells, and white blood cells. Their findings may be rare, due to the neutrophil-preventing efficiency, and possibly misidentification as fine granular.
Cell epithelial cells
This cast is formed by the inclusion or adhesion of desquamated epithelial cells from the tubular layer. Cells can stick in random order or in sheets and are distinguished by large round nuclei and lower cytoplasm counts. This can be seen in acute tubular necrosis and toxic consumption, such as from mercury, diethylene glycol, or salicylate. In each case, clumps or sheets of cells can be peeled off simultaneously, depending on the focality of the injury. Cytomegalovirus and hepatitis virus are organisms that can cause epithelial cell death as well.
Eosinophilic cast
This type of cast contains eosinophils. This is seen in Tubulo Interstitial Nephritis and occurs in allergies, commonly for drugs such as Methicillin & amp; NSAIDs.
References
- Haber, Meryl H. Urine Sediment: An Atlas of a Lesson Book . American Society of Clinical Pathologists. Chicago, 1981.
- Lillian Mundt, Kirsty Shanahan, Graff Textbook on Urinealysis and Body Liquor Routine , second edition, Lippincott Williams & amp; Wilkins, Philadelphia, 2011.
External links
- Urine Casts - different types and what they mean.
- [1] - A good description of the different forms of players.
Source of the article : Wikipedia
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