Скачать или смотреть Red blood cells (RBC) Cast in Urine microscopy of renal patient

Red blood cell (RBC) casts in urine microscopy are a strong indicator of glomerular bleeding and are often seen in renal patients with conditions like glomerulonephritis or other glomerular diseases. They signify that red blood cells have entered the urinary tubules and are trapped within a protein matrix.
Key points about RBC casts:
Formation:
RBC casts form when red blood cells, having entered the nephron (the functional unit of the kidney), become embedded in a protein matrix called Tamm-Horsfall protein.
Glomerular Origin:
The presence of RBC casts, particularly when coupled with dysmorphic (abnormally shaped) red blood cells, strongly suggests a glomerular source of bleeding.
Clinical Significance:
RBC casts are not a normal finding and can be associated with various kidney conditions, including:
Glomerulonephritis: Inflammation of the glomeruli, the filtering units of the kidney.
Vasculitis: Inflammation of blood vessels, which can affect the kidneys.
Acute Interstitial Nephritis: Inflammation of the kidney tissue between the tubules.
Renal Infarction: Blockage of blood flow to a portion of the kidney.
Diabetic Nephropathy: Kidney disease caused by diabetes.
Other Glomerular Diseases: A variety of other conditions that affect the glomeruli.
Appearance:
RBC casts can vary in appearance, with some containing only a few red blood cells while others are densely packed, making individual cells and the protein matrix difficult to see.
Dysmorphic RBCs:
The presence of dysmorphic red blood cells, such as acanthocytes (ring-shaped cells with blebs), further supports a glomerular origin for hematuria (blood in the urine).
In summary: Finding RBC casts in the urine of a renal patient strongly suggests a glomerular source of bleeding and warrants further investigation to determine the underlying cause and appropriate management.
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