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This latest iteration incorporates phase contrast microscopy in addition to bright field, to improve differentiation of elements such as hyaline casts, red cell membranes, crystals, and yeast.
The prominent signs of renal injury in this patient were the increase in Scr and BUN, persistent proteinuria, and a few of hyaline casts.
Blood and protein were present in the urine (Table 1) and that many hyaline casts were seen per low power field.
The upper reference limits for phase-contrast microscopy used in our laboratory are as follows: erythrocytes, <2/high-power field (HPF); leukocytes, <4/HPF; small-sized hyaline casts, <4 in each slide; hyaline with medium or large diameter, cellular, granular, granulo-hematic, waxy casts, none; cystine crystals, none; other crystals, rare (<10 in each slide).
Urinary findings in active LN include albuminuria, leukocyturia, hematuria, granular casts, hyaline casts, red blood cell casts, fatty casts, and oval fat bodies.
RBC, WBC, squamous epithelial cells, hyaline casts, and bacteria are enumerated.