Maltese Cross Sign Nephrotic Syndrome

The appearance of the maltese crosses is due to the birefringence of lipid droplets which consist mainly of cholesterol esters.

Maltese cross sign nephrotic syndrome. The classic maltese cross pattern is evident in fatty casts with polarized microscopy because of the birefringence of the lipid. If cholesterol or cholesterol esters are present they are associated with the maltese cross sign under polarized light. They are pathognomonic for high urinary protein nephrotic syndrome. Nephrotic syndrome is a collection of symptoms due to kidney damage.

Formed by the breakdown of lipid rich epithelial cells these are hyaline casts with fat globule inclusions yellowish tan in color. Other symptoms may include weight gain feeling tired and foamy urine. Maltese crosses in the nephrotic syndrome a 66 year old man presented with edema which had developed over the previous month. Images in clinical medicine from the new england journal of medicine maltese crosses in the nephrotic syndrome.

Download citation images in clinical medicine. Maltese crosses are due to cholesterol which is increased in nephrotic syndrome. Complications may include blood clots infections and high blood pressure.