Urine Sediment of the Month: Mixed Cellular Casts

707 0


As we have covered before, RBC casts most often signify the presence of glomerulonephritis while WBC casts are indicative of an inflammatory process affecting the glomeruli or interstitium. Sometimes, casts can be seen which contain both red and white blood cells.


Here we see several examples of mixed cellular casts. All images are under brightfield illumination with Sternheimer-Malbin stain using Olympus 100x/1.25NA oil objective.

A mixed cell cast in the urine of a patient with crescentic IgAN

These mixed casts are usually associated with an acute proliferative glomerulonephritis or vasculitic process- that is, disorders in which there is intense inflammation and damage affecting the glomeruli.

A mixed cell cast in the urine of a patient with microscopic polyangiitis

When tubular epithelial cells are also within casts there is almost certainly some degree of acute tubular injury as well.

A mixed cell cast in the urine of a patient with hydralazine-induced vasculitis

Post by Jay Seltzer

Reviewed by Anna Gaddy

Leave a Reply