Question

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A urine specimen is collected from a 7-year-old girl with a history of several recent infections. She is seen because of lethargy, pallor, and facial edema and is found to have generalized edema. The urine specimen is pale but noticeably foamy.

Urinalysis Results:

Physical Appearance:
color:	pale
transparency:	hazy
foam: Chemical Screening:	large quantity, white
pH:	6
specific gravity:	1.010
protein (strip)	>2000 mg/dL protein (SSA) 4+
blood	negative
nitrite	negative
leukocyte esterase	negative
glucose	negative
ketones	negative
bilirubin	negative
urobilinogen	normal

Microscopic examination of the urine sediment:

red blood cells	0-2/hpf
white blood cells	0-2/hpf 2-5 fatty casts/lpf 5-10 hyaline casts/lpf
epithelial cells	moderate oval fat bodies few renal few squamous
other	moderate fat globules

1. What urinalysis findings are abnormal or discrepant?
2. Vlhat is causing the large amount of white foam in this urine specimen?
3. Explain the edema exh1Yted by this patient in terms of the urinalysis findings.
4. What are oval fat bodies and what do they signify in this patient?
5. What is the name of the syndrome exhibited by this patient?

Answer 1

1) among all the findings

protein amount more than 2000 mg / dL

Presence of blood cells- RBC, WBC in the urine

And presence of white foam in the urine all are abnormal constitute in urine.

2).Protein present in  urine ,lowers the surface tension cause foamy urine.

3) as large amount of protein are being lost every day in urine. Protein play an important role in maintaining osmotic balance in the body and regulate distribution of water among extracellular fluid and intracellular fluid. In absence or decrease level of protein , in decrease level of urine large amount of water retained in the body and lead to oedema.

4) oval fat bodies present in urine are due to liquria in the urine. And the tubular cells that absorb the lipoprotein are shed off this lead to loss of lipids.

5) all the features mentioned above are best fit in nephrotic syndrome.