Diagnose This (May 21, 2018)
What is your diagnosis?
The photomicrograph shows beaded, lightly pigmented casts within tubules that are consistent with myoglobin casts and below, an immunoperoxidase stain for myoglobin confirms this diagnosis. Of note, myoglobin casts and hemoglobin casts cannot always be distinguished from each other by morphology alone. And, in most cases, immunoperoxidase staining for hemoglobin and myoglobin can easily facilitate differentiation.
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