Maltese Cross Sign Nephrotic Syndrome

The urinary sediment showed fatty casts panel a with typical maltese crosses under polarized light panel.

Maltese cross sign nephrotic syndrome. Urinalysis demonstrates 4 protein and fatty casts with a maltese cross sign. Fatty casts with maltese cross sign. Focal segmental glomerulosclerosis. They are pathognomonic for high urinary protein nephrotic syndrome.

The arms of the maltese crosses seen in these patients with gross proteinuria are symmetrical figure 2. It is also examined for active casts. The following are baseline essential investigations urine sample shows proteinuria. Maltese crosses are due to cholesterol which is increased in nephrotic syndrome.

Nephrotic syndrome is defined as urinary excretion of 3 g of protein in a 24 hour urine sample due to a glomerular disorder plus edema and hypoalbuminemia. Maltese crosses in the nephrotic syndrome a 66 year old man presented with edema which had developed over the previous month. Nephrotic syndrome 11 4 2012 69 views 5 topic comments 36 please. A 66 year old man presented with edema which had developed over the previous month.

Which is more a feature of active nephritis. Formed by the breakdown of lipid rich epithelial cells these are hyaline casts with fat globule inclusions yellowish tan in color. Fatty casts with maltese cross sign. Podocyte injury or decreased glomerular filtration barrier integrity.

Consider nephrotic syndrome in patients particularly young children with unexplained edema or ascites. Treat underlying etiology in secondary causes. Acute poststreptococcal glomerulonephritis. Hypoalbuminemia hyperlipidemia and lipiduria.

Focal segmental glomerulosclerosis. If cholesterol or cholesterol esters are present they are associated with the maltese cross sign under polarized light. Download citation images in clinical medicine. Fatty casts with maltese cross sign.

The classic maltese cross pattern is evident in fatty casts with polarized microscopy because of the birefringence of the lipid.