Urinalysis Case Study - Cholesterol Crystals
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What are Cholesterol Crystals?
Cholesterol crystals may be seen in the urine of patients with nephrotic syndrome and are generally accompanied by fatty casts, free fat globules and oval fat bodies. The urine may have an overall cloudy white appearance, indicating the presence of chyle. Cholesterol crystals are apparent when a sample is refrigerated, allowing the lipids to remain in droplet form.
Cholesterol crystals may be an indication of renal tubular disease, which, if left untreated, can lead to kidney failure. Because of the significance of cholesterol crystals, it is important not to confuse them with uric acid crystals, which are commonly seen in acidic urine. Under polarized light, the sheets of crystals are highly birefringent and may exhibit a stained glass effect.
Morphology/Features:
- Sheet-like shapes of skewed rectangles or squares
- Commonly display indented corners, giving a staircase appearance
- Found in acid or neutral urine
- Urine has a milky white appearance (chylous)
- Dissolves in chloroform and ether
Resources:
Color Atlas of the Urinary Sediment, College of American Pathologists, Northfield, IL. UF-Series Clinical Case Study Volume 2, Sysmex Corporation, Kobe, Japan.
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