Maltese Cross Sign Nephrotic Syndrome

Maltese crosses are due to cholesterol which is increased in nephrotic syndrome.

Maltese cross sign nephrotic syndrome. Nephrotic syndrome is characterized by a massive renal loss of protein 3 5 g day resulting in edema hypercoagulability antithrombin iii deficiency and an increased risk of infection loss of immunoglobulins typical laboratory findings of nephrotic syndrome include hyperlipidemia and fatty casts on urinalysis the most common causes of nephrotic syndrome in adults are focal segmental. Renal disease such as nephrotic syndrome produces a fatty cast composed of cholesterol that also has a maltese cross appearance on light microscopy. Focal segmental glomerulosclerosis. Fatty casts with maltese cross sign.

Hypoalbuminemia hyperlipidemia and lipiduria. Formed by the breakdown of lipid rich epithelial cells these are hyaline casts with fat globule inclusions yellowish tan in color. Nephrotic syndrome 11 4 2012 69 views 5 topic comments 36 please. Nephrotic syndrome is usually caused by damage to the clusters of small blood vessels in your kidneys that filter waste and excess water from your blood.

Maltese cross the classic maltese cross pattern is evident in fatty casts with polarized microscopy because of the birefringence of the lipid. This is often referred to as a maltese cross sign because of the resemblance of the tetrad to the cross on peripheral blood smear. Nephrotic syndrome is a kidney disorder that causes your body to pass too much protein in your urine. They are pathognomonic for high urinary protein nephrotic syndrome.

The appearance of the maltese crosses is due to the birefringence of lipid droplets which consist mainly of cholesterol esters. Round particles producing birefringent maltese crosses under polarized light are commonly seen in the urinary sediment of patients with a nephrotic syndrome. It s also important to remember that one of the secondary changes in individuals with nephrotic syndrome is that the liver will increase lipoprotein synthesis which results in hyperlipidemia. The urinary sediment showed fatty casts panel a with typical maltese crosses under polarized light panel.

Consider nephrotic syndrome in patients particularly young children with unexplained edema or ascites. A 66 year old man presented with edema which had developed over the previous month. Fatty casts with maltese cross sign.