Case Study: Female with Painful Urination Answers



3. The formed element shown below is a granular cast.  The presence of these are always pathological and are commonly found in patients who have renal disease.  They are formed by the decreased and slowed urine flow through the renal tubules.  In this case, these granular casts were probably once WBC casts (which are also present in the patient).  The white blood cells found in the casts were sitting in the tubules long enough to cause degradation of the cells leading to the formation of granular casts.



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