[CM] Urine Crystals

Calcium oxalate

-Non-pathologic; seen in acidic pH
-Cause by eating foods like spinach, rhubarb, tomatoes, garlic, oranges, or asparagus
-Also due to eating lots of asorbic acid or ethylene glycol poisoining

Uric acid

-Normal crystals in acidic pH
-Pleomorphic and many colors under polarizing light

Triple phosphate

-Normal crystals in alkaline pH

Calcium carbonate

-Normal crystals in alkaline pH

Ammonium biurate

-Normal crystals seen in alkaline pH

Bilirubin

-Acidic urine
-Seen in liver disease; obstruction to bile flow, cholestasis, or hepatitis

Cholesterol crystals

-Abnormal crystals
-Rare; associated with nephrotic syndrome (excretion of oval fat bodies and fatty casts)

Cystine crystals

-Abnormal crystals

Leucine crystals

-Abnormal crystals

Tyrosine crystals

-Abnormal

Sulfa crystals

-Abnormal
-Note the exocentric binding

Acyclovir crystals

-Abnormal

Indinavir crystals

-Abnormal

Sulindac (Clinoril)

What drug do sulfone metabolite crystals (eccentric binding) come from?

Trichimonas vaginalis

-Common cause of urinary tract infections
-Can look like WBCs in older urine

Schistosoma haematobium

-Trematode that is common in the Middle East
-Intermediate snail host is not found in the US, so this disease is not endemic here
-Associated with bladder cancer

Enterobius vermicularis

-Most common helminth infection in US; can see eggs in urine due to fecal contamination