I requested a urine sediment analysis because of elevated serum uric acid…
.
.
…and received this sample. 👀

Can you guess what we found under the microscope? 🔬

#UrinarySediment

Female, 40 yo, LES class IV, cr 3.11 (previous 0.8), hematuria, proteinuria.

U-Sed: RBC cast, presence of leukocytes (glitter cells?)

#Urinarysediment #urineMicroscopy

Dysmorphic hematuria

#Urinarysediment #urinemicroscopy

First case of the Year 🫶

Male, 50 years old, recently started dialysis, persistent hematuria?

Ph 8.0 sg: 1005 hb +

💦 Urinary sediment: leukocytes, some macrophages, and triple phosphate crystals. No RBC

Urine culture pending

#UrinarySediment #urineMicroscopy

Woman, 71 yo, allopurinol user, U-Sed: Uric acid crystals.

*First time I've seen crystals; How beautiful these crystals are! 😍 can't imagine how excited I am. Maybe only a few will understand 🤭 Happy New Year 2026! May there be more urinary sediments to explore

#urinarysediment #urinarymicroscopy

2/n UPCR 0.7 g/g; #UrinarySediment reveals acanthocytes, WBC casts and mixed WBC/RBC casts (SM stain).

WBC cast with numerous "glitter cells" - phase contrast - from patient with suspected acute interstitial nephritis - #UrineMicroscopy #UrinarySediment

#UrinarySediment from a pt with #AKI #RPGN due to suspected MPO-AAV-GN inspected with Sternheimer stain: WBC cast (bright field), broad RBC cast (bright), waxy cast (bright), and granular cast w/Ca Oxalate monohydrate crystals (oblique). #OchsnerNephrology #UrineMicroscopy

#UrinarySediment from a pt with #AKI #RPGN due to suspected MPO-AAV-GN inspected with Prescott-Brodie stain: RBC cast (bright field, 2 WBCs in cast), WBC cast (bright field, a few RBCs in it), lipid cast (dark field), and renal tub epi cell cast (oblique, many WBCs in blue around) #OchsnerNephrology

#UrinarySediment from a pt with #AKI #RPGN due to suspected MPO-AAV-GN inspected with Sternheimer-Malbin stain: RBC cast (bright field), WBC cast (oblique illumination), fibrinous cast (dark field), and renal tub epi cell cast (oblique). #OchsnerNephrology

Mixed cellular casts - brightfield with SM stain - #UrinarySediment #UrineMicroscopy

11. Another highlight was to meet (Ana Paula Franz and Carlos Martinez-F) for the first time 2 of our coauthors of our transcontinental collaboration to describe for the first time the clinical phenotype associated with vacuolar casts in the #UrinarySediment pdfs.journals.lww.com/kidney360/20...

2. Hands-on pre-course. We started with demonstration of microscope techniques, stains and #UrinarySediment structure identification. The organizers brought great specimens, even one containing vacuolar casts!

Bilirubin crystals under polarized light #UrineMicroscopy #UrinarySediment

Another day here! at the Urinary Sediment Unit, we continue learning 😎 #UrinarySediment

#UrinarySediment
16yo female, admitted with hematuria and RPGN (Creat 0.7 > 4mg/dL),
#UrineMicroscopy showed RBC cast, acanthocytes.

#UrinarySediment
46yo male, with necrotizing scleritis and c-ANCA vasculitis.
#UrineMicroscopy showed RBC cast, mixed casts (leucocytes + RBC + lipids), acanthocytes

After a fun and productive #KidneyWk, I’m right back in ✈️ mode again, this time heading to Santiago to share and learn more within the #UrinarySediment #UrineMicroscopy South American Lab/Pathol/Nephrol community 🇵🇪🇨🇱

I met a clever renal fellow at #KidneyWk who named his pets Ace and Arb. I’m inspired. I’ll name my next puppies Muddy and Waxy #UrinarySediment

Had the pleasure of meeting The Vancomycin Cast guy, @yosuluque.bsky.social at #KidneyWk and chat about #PrecipitousAKI, organic transporters, #UrinarySediment and more

30 y/o man, with hx GPA 15 years ago, presents with vasculitic rash, pulm infiltrates, and AKI with rapid worsening. DAH on bronch. #UrineMicrosopy showed RBC cast, WBC cast, and tubular cell cast - brightfield with SM stain. #UrinarySediment

Thanks @amyaimei.bsky.social for giving an excuse to share some #UrinarySediment pics. See below for context 👇🏼

Glitter cells
#UrinarySediment
#UrineMicroscopy

Glitter cells
WBC’s exhibiting granular motility may be called “glitter cells”, Sternheimer-Malbin cells”, or “granular motility cells”. Although they were once thought to be pathognomonic for pyelonephritis they are a non specific finding
#UrinarySediment
#UrineMicroscopy

The urine in glomerulonephritis really glows ✨
#urinarySediment

🔬for the diagnosis of glowmrulonephritis, searching for urinary acanthocytes only using bright field illumination is clearly suboptimal compared to utilizing dark field illumination or phase contrast microscopy. #UrinarySediment #UrineMicroscopy karger.com/gdz/article/...

Mixed cellular containing RBCs, WBCs (blue) and RTECs (fuchsia) in the #UrinarySediment from a patient with suspected IgA nephropathy 🔬bright field (500x) and oblique illumination (1000x) #UrineMicroscopy #OchsnerNephrology

Clinic visit, pt w/type 2 diabetes + nephrotic range proteinuria. Persistent hematuria noted (normal cysto 3 mo ago) not c/w diabetic nephropathy. #UrinarySediment 🔬is performed: numerous acanthocytes and a few WBC casts. Serum IgA elevated. Normal C3/C4. Other tests pending. Kidney biopsy planned

In this picture, we were unsure if it was a red blood cell cast or a red blood cell cluster due to its shape. What do you think?
#UrinarySediment #Urinemicroscopy

Presence of casts:
- Waxy Cast with Erythrocytes (SM stain)

#urinarySediment #uSed