Urine urobilinogen

Condition Serum Bilirubin Urine Urobilinogen Urine Bilirubin Fecal Urobilinogen... 

In jaundice secondary to hemolysis, the increased production of bilirubin leads to increased production of urobilinogen, which appears in the urine in large amounts. Bilirubin is not usually found in the urine in hemolytic jaundice (because unconjugated bihmbin does not pass into the urine), so that the combination of increased urobilinogen and absence of bihmbin is suggestive of hemolytic jaundice. Increased blood destruction from any cause brings about an increase in urine urobilinogen. 

A patient has highly elevated serum indirect bilirubin and urine urobilinogen and a very slightly elevated serum direct bilirubin. What is the most likely diagnosis ... 

As there is a lot of urine urobilinogen, the liver must be conjugating the bilirubin, and it is moved into the intestinal tract where urobilinogen is formed. An increase in serum indirect (unconjugated) bilirubin indicates hemolytic disease. 

Renal Effects. In a case of chronic phenol poisoning, dark urine and glucose in the urine were noted in a man following intermittent exposure to vapors and solutions of phenol (Merliss 1972). The urine tested negative for protein and urobilinogen. The urine cleared 2-3 months after removal from exposure. Although the exposure concentrations were not reported, the study author stated that heavy odors were often detectable, and that phenol was often spilled on the patient s clothes resulting in skin irritation. Since phenol is absorbed readily from the skin, dermal absorption may have contributed to the systemic effects that were observed. 

Phenothiazines may increase serum cholesterol, spinal fluid protein, and urinary urobilinogen levels decrease protein bound iodine yield false-positive urine bilirubin tests interfere with urinary ketone and steroid determinations. 

Drug/Lab test interactions False-positive tests for urobilinogen may occur during nizatidine therapy. False-positive tests for urine protein with Multistix may occur during ranitidine therapy testing with sulfosalicylic acid is recommended. 

Lab test abnormalities Aminosalicylic acid has been reported to interfere technically with the serum determinations of albumin by dye-binding AST by the azoene dye method and with qualitative urine tests for ketones, bilirubin, urobilinogen, or porphobilinogen. 

A negative and positive control sample (pooled urine, spiked with urobilinogen/ PBG) is run with each batch of patient samples. 

To measure the urobilinogen content of the urine samples, use Urobilistix strips, one for each urine sample. Dip them into the samples and remove the excess urine by tapping the strips against a clean, dry surface. Sixty seconds after wetting, compare the color of the test area of the strips to the color chart provided on the bottle. Estimate the urobilinogen content and record it in Ehrlich units. 

The urine examination revealed no abnormality except an increase of urobilinogen. The erythrocyte sedimentation rate was increased (45 mm per hour normal is <20 mm per hour). 

In pernicious anemia (PA), the urine contains excess urobilinogen, and gastric analysis reveals histamine-fast achlorhydria. Laboratory examina-... 

Bilirubin digiucuronide is excreted from the liver via the bile into the intestine. Within the bowel, it is hydrolyzed, and the bilirubin is reduced to urobilinogen and stercobilinogen. These are excreted in urine as urobilin after reabsorption from the bowel, and in feces as stercobilin these pigments give urine and feces their characteristic colors. 

Ehrlich s aldehyde test can be used to confirm a diagnosis of acute intermittent porphyria. Equal volumes of urine and Ehrlich s reagent are mixed a pink colour indicates raised urinary concentration of either porphobilinogen or urobilinogen. In acute intermittent porphyria, raised porphobilinogen is present and the pink precipitate formed is insoluble in chloroform. 

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