Granular casts are the second most common cast found in urine, after hyaline casts. Granules are thought to be degraded cellular casts or aggregates of plasma proteins. Granules start coarse and become fine as breakdown continues.
Few of these casts can be seen in healthy individuals. Increased amounts may be seen after strenuous exercise and in renal disease.
Appearance
Granular casts are composed of fine or coarse granules in a protein matrix. They should have a clearly defined shape.
Lookalikes
Amorphous crystals can be mistaken for granular casts when they clump together. However, casts will have a clear form while these clumps will not. The crystals can be dissolved with heat for better visualization of other elements.
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