The identification and proper characterization of pathologic renal intratubular casts can be an arduous task, especially since they often admixed with non-pathologic casts, obfuscating debris and inflammation. The list of pathologic intratubular casts is long, and they can be easily missed or misdiagnosed without a thorough understanding of their pathophysiology and morphologic variety. Correct characterization of tubular casts is important since each cast type has a unique pathogenic mechanism, with specific treatment and prognostic implications. This review discusses the clinicopathologic characteristics of the six most common pathologic casts: light chain, hemoglobin, myoglobin, red cell, neutrophilic and bile casts. We also discuss hyaline and uromodulin casts, the commonly encountered "benign" cast types that share certain histologic features with pathologic casts. We limit the discussion to proteinaceous and cellular intratubular casts, with crystalline casts discussed in a separate review within the same journal issue. While not exhaustive, this review covers pathogenesis, clinical and prognostic significance, and a practical discussion of the histomorphologic spectrum of each cast type, along with commonly encountered pitfalls.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1053/j.semdp.2020.02.001 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Diuretics for preventing and treating acute kidney injury.
Cochrane Database Syst Rev
January 2025
Department of Psychiatry, Soseikai General Hospital, Kyoto, Japan.
Background: Acute kidney injury (AKI) is a well-known complication of critical illnesses, significantly affecting morbidity and the risk of death. Diuretics are widely used to ameliorate excess fluid accumulation and oliguria associated with AKI. Their popularity stems from their ability to reduce the energy demands of renal tubular cells by inhibiting transporters and flushing out intratubular casts.
View Article and Find Full Text PDFClinicopathological features for the prediction of immunosuppressive treatment responses in sarcoidosis-related kidney involvement: a single-center retrospective study.
Turk J Med Sci
December 2024
Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, İstanbul University, İstanbul, Turkiye.
Background/aim: Sarcoidosis is a multisystem disorder that affects many organs, including the kidneys. This single-center retrospective study investigated the clinical, pathological, and laboratory findings of patients with kidney sarcoidosis who were treated with immunosuppressives.
Materials And Methods: Twenty-three patients with biopsy-confirmed kidney sarcoidosis were included.
An Overlap of Anticoagulant-Related and IgA Nephropathy: A Case Report.
Glomerular Dis
August 2024
Department of Pathology Arkana Lab Little Rock, Little Rock, AR, USA.
Article Synopsis
- Anticoagulant-related nephropathy (ARN) is becoming more recognized as a cause of acute kidney injury (AKI), especially in patients using warfarin, and now also needs scrutiny for direct oral anticoagulants (DOACs).
- A case study showed a 64-year-old male with paroxysmal atrial fibrillation treated with DOACs, presenting with heart failure and AKI, which was linked to kidney damage and underlying IgA nephropathy.
- The findings highlight the need for clinicians to be vigilant about the potential risk of ARN in patients on DOACs, especially when they exhibit symptoms of AKI, emphasizing early diagnosis for better patient outcomes.
Histopathologic and ultrastructural findings in oak ( spp.) toxicity on 2 beef cattle farms in Colorado.
J Vet Diagn Invest
January 2025
Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biological Sciences, Colorado State University, Fort Collins, CO, USA.
Article Synopsis
- - Natural oak toxicity occurs when ruminants like cattle consume parts of oak trees, leading to severe health issues due to the breakdown of plant tannins by gut microbes and enzymes.
- - Symptoms of acute oak toxicity resemble those of renal disease, specifically acute tubular injury, which can be fatal.
- - A study of three beef calves in Colorado revealed significant kidney damage and unique microscopic features of oak-induced toxicity, highlighting previously undocumented effects on renal tissues and blood vessels.
Paraneoplastic Cast Nephropathy Associated With Pancreatic Acinar Cell Carcinoma: A Kidney Biopsy Teaching Case.
Kidney Med
October 2024
Department of Pathology, Duke University Health Systems, Durham, NC.
Paraneoplastic cast nephropathy, a rare cause of acute kidney injury, is most commonly observed in cases of multiple myeloma and is characterized by the formation of intratubular casts composed of monoclonal light chains. Nonmonoclonal paraneoplastic cast nephropathy has also been reported in patients with pancreatic acinar cell carcinoma or prolactinoma. In this case report, we present a case of polyclonal cast nephropathy in a patient with metastatic acinar cell carcinoma.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!