Which lipid-related sediment element was observed occasionally in the nephrotic syndrome case?

• A. Red blood cells
• B. Oval fat bodies
• C. Fatty casts
• D. Ketone bodies

Answer: (B)

Lipiduria is a hallmark of nephrotic syndrome, where the liver ramps up lipoprotein production and lipid droplets accumulate in renal tubular cells. The sediment element that best reflects this lipid burden is oval fat bodies—renal tubular epithelial cells that have become engorged with lipid droplets and are shed into the urine. They appear as oval, refractile bodies and can show a Maltese-cross pattern under polarized light due to their lipid content. Red blood cells indicate bleeding rather than lipiduria, ketone bodies reflect altered metabolism, and fatty casts can occur but are not as specific to lipid-laden tubular cells as oval fat bodies.