Urinanalysis (UA): a neglected but easy and inexpensive diagnostic tool

Abstract

The case history of a 75-year-old woman, who was hospitalized with the diagnosis of an acute erosive colitis, is presented. The patient was treated with hysterectomy for an endometrial cancer in 2000 and had suffered from multiple sclerosis for 15 years. A persistent non-productive cough with fever requested a pneumological consultation. Multiple small alveolar opacities and cavitating lesions were found at chest imaging, but no precise diagnosis was possible. Only 3 weeks after hospitalization, we noticed that a urine analysis had been forgotten. This additional test clearly demonstrated a nephritic sediment and further analysis confirmed the diagnosis of a ANCA-positive microscopic polyangiitis, which promptly responded to immunosuppressive therapy. The necessity of a routine urine analysis in the majority of internal medicine patients and the possible link between small vessel vasculitis and multiple sclerosis are discussed.

Atypical case of AL amyloidosis with urinary erythrocyte casts

“…Evaluation of urinary sediment is essential for the diagnostic work-up of many nephrological problems as urinary sediment findings aid in the differential diagnosis of renal disease [ 1 , 2 ]. Some findings are considered particularly specific for certain groups of diseases, such as the finding of erythrocyte casts, which typically points to the presence of glomerular inflammation or bleeding, as is the case in glomerulonephritis [ 3 , 4 , 5 , 6 ]. Here we describe a case of a patient presenting with numerous urinary erythrocyte casts, in whom no glomerulonephritis, but rather renal AL amyloidosis was found on biopsy.…”