ZSFG AM Report Pearls 12/6/17: Can You Paint with All the Colors of the Urine?……Yes. You. Can.

Thank you to Mike for presenting a case of a man with hematuria/”dark urine” who ultimately was found to have a large pelvic mass extending into the scrotum, removed by Urology with pathology pending. This case brought up the differential of all the things that can discolor your urine.

 

Differential Diagnosis for Discolored Urine:

White/Yellow
Pyuria, phosphate crystals, chyluria, Propofol
Pink
Uric acid crystals (may be 2/2 Propofol)
Green
Food dye

Meds: Amitriptyline, indomethacin, propofol

Familial benign hypercalcemia: sometimes called, “blue diaper syndrome,” because children with this disorder have blue urine

Black
Ochronosis (black urine disease 2/2 excretion of homogentisic acid)
Purple
Bacteruria (esp with Providencia, Klebsiella, Proteus)
Red
Blood: hematuriaMyoglobinuria (eg rhabdomyolysis)

Foods: Beets, blackberries, rhubarb

Medications: Rifampin, Pyridium, senna-containing laxatives, sulfasalazine

Brown
Urocolonic fistula
Darker Than Normal
Bilirubin (biliary obstruction or liver injury)

Food: fava beans, aloe

Meds: anti-malarials (chloroquine, primaquine), Flagyl

Porphyria

Glomerulonephritis (dysmorphic RBCs)

 

 

Evernote:

  • DDx for Discolored Urine: https://www.evernote.com/shard/s509/sh/8582ac3a-de7f-4a8e-91a2-624f1d51e1c5/3c444537fab2540d80040e9d9e40e00f

 

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s