Case Study # 1

Iga Nephropathy Patient Returns

 Case #1: Iga Nephropathy Patient Returns ANSWER

2)      What is the significance of waxy casts in this patient’s specimen and does this correlate with his oliguria?

Casts form in the renal tubules from a matrix of gelled uromodulin (a normal protein native to the kidney).  When casts form with cellular inclusions, they are always considered pathological.  As time passes, the cells in cellular casts degrade into granular casts.  Granular casts then degrade into waxy casts as more time passes.  Therefore, the presence of waxy casts indicates that cells were present in the renal tubules and that urine was not passed regularly (because the casts had enough time to degrade inside the patient).  Oliguria (decreased urine excretion) correlates perfectly with waxy casts.  

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