Under polarized light certain elements in the urine sediment may show a "Maltese" cross. It is important to distinguish between those elements producing the "true" Maltese cross and those elements that may mimic it (pseudo-Maltese cross).


Maltese Cross


Associated with


arms of equal length and uniform width, crossing in the middle of the object

fat and fat bodies (lipiduria)

false (pseudo)

arms of unequal length OR arms with variable width OR eccentric crossing

starch, leucine, triamterene, 2,8-DHA



• 2,8-DHA = 2,8-dihydroxyadenine

• 2,8-DHA is associated with adenine phosphoribosyltransferase (APRT) deficiency and appears as small brown spheres.

• Triamterene is a potassium-sparing diuretic.


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