Maltese Cross Sign Fatty Casts

They are pathognomonic for high urinary protein nephrotic syndrome.

Maltese cross sign fatty casts. John now the. It is a heraldic cross variant which developed from earlier forms of eight pointed crosses in the 16th century. When lipiduria occurs epithelial cells or macrophages contain endogenous fats. Crystals in acid urine.

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. Renal disease such as nephrotic syndrome produces a fatty cast composed of cholesterol that also has a maltese cross appearance on light microscopy. 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. Start this article has been rated as start class on the project s quality scale.

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. Formed by the breakdown of lipid rich epithelial cells these are hyaline casts with fat globule inclusions yellowish tan in color. Fatty degeneration of the tubular epithelium in degenerative tubular disease. It has also been reported as a sign following fat embolism.

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 casts oval fat bodies maltese cross pattern under polarized light. Fatty casts are characteristic of degenerative tubular disease and are frequently associated with heavy proteinuria. Uric acid many different shapes diamond rhombic prism or rosette.

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. Although chiefly associated with the knights hospitaller order of st. If cholesterol or cholesterol esters are present they are associated with the maltese cross sign under polarized light. Under polarized light oval fat bodies demonstrate the maltese cross appearance.

This formation is indicated by the white arrow in the bottom image. 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.