Maltese Cross Sign Fatty Casts

Because of the maltese cross interference pattern when viewed under polarized light the fatty casts are easy to identify.

Maltese cross sign fatty casts. Lipiduria or lipuria is the presence of lipids in the urine lipiduria is most frequently observed in nephrotic syndrome where it is passed as lipoproteins along with other proteins. It is a heraldic cross variant which developed from earlier forms of eight pointed crosses in the 16th century. The fatty casts are casts that contain lipid droplets sequestrated in a hyaline matrix. When lipiduria occurs epithelial cells or macrophages contain endogenous fats.

This formation is indicated by the white arrow in the bottom image. In the first type the embedded fat droplets are parsed in the hyaline matrix. Notably our patient had only moderate proteinuria no clinical signs of a nephrotic syndrome and the arms of the maltese crosses were asymmetric and irregular. Fatty casts containing cholesterol will produce classic maltese cross formations under polarized light.

This type should be reported as a hyaline fatty cast. Lipid droplets associated with gross proteinuria are round and translucent without internal structure whereas the particles in our patient were of roundish to polygonal shape colourless and had a nucleus like centre a pattern which. Fatty casts oval fat bodies maltese cross pattern under polarized light. John now the.

It has also been reported as a sign following fat embolism. Uric acid many different shapes diamond rhombic prism or rosette. Renal disease such as nephrotic syndrome produces a fatty cast composed of cholesterol that also has a maltese cross appearance on light microscopy. Maltese cross is within the scope of the heraldry and vexillology wikiproject a collaborative effort to improve wikipedia s coverage of heraldry and vexillology if you would like to participate you can visit the project page where you can join the project and see a list of open tasks.

Crystals in acid urine. This is often referred to as a maltese cross sign because of the resemblance of the tetrad to the cross on peripheral blood smear. Fatty degeneration of the tubular epithelium in degenerative tubular disease. They are pathognomonic for high urinary protein nephrotic syndrome.

Although chiefly associated with the knights hospitaller order of st. Start this article has been rated as start class on the project s quality scale. The urinary sediment showed fatty casts panel a with typical maltese crosses under polarized light panel b and was otherwise unremarkable with no sign of nephritis. The maltese cross is a cross symbol consisting of four v or arrowhead shaped concave quadrilaterals converging at a central vertex at right angles two tips pointing outward symmetrically.

In the netherlands the maltese cross forms the basic form for the three highest royal orders. If cholesterol or cholesterol esters are present they are associated with the maltese cross sign under polarized light.