A patient presents with hematuria of several days and dysmorphic RBC casts in urine. The site of origin is :

Clinical Significance Of different casts: Hyaline casts A normal constituent of urine and has no attatched significance Tom Horsfall protein is protein secreted by epithelial cells of loop of henle. This protein may be excreted as Hyaline cast. RBC Cast Are suggestive of glomerular injury or acute glomerular injury or glomerulonephritis WBC Casts Are suggestive of interstitial injury and may be seen in interstitial nephritis WBC casts with bacteria indicate pyelonephritis Blood granular casts Are seen in CRF and suggests interstitial fibrosis and dilatation of tubules Pigmented muddy brown granular casts Are suggestive of ischemic or nephrotic injury (Tubular Necrosis) Ref: Smith 18th edition Pgno: 51