Tuesday, October 16, 2012

iSEDIMENT

Cast A
Cast B
I have spent the past 1 month on the renal consult service at the Brigham. And, after nearly 25 years as a nephrologist I can still struggle with a urine sediment. An example: distinguishing a renal tubular epithelial cell cast from a white cell cast. Take a look at the two casts above and tell me which one is the white cell cast and which one the renal tubular epithelial cell cast. Not so easy!
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1 comment:

  1. Yes, not easy, but- I think:
    Cast A: looks like a WBC cast, Cast B looks like an epithelial cast.
    I find that the cell in the Epithelial cast are bigger ( since the cells are bigger than the WBCs)- BUT, I usually can tell since I can compare with other cells around.

    I also noticed that the WBC casts leaves some spaces between cells, so you can have gaps with no cells in the WBC cast.

    But, I might be wrong!

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