Uroscopic rainbow: modern matula medicine

Foot, Carole; Fraser, John F.

doi:10.1136/pgmj.2005.037598

Cited by 26 publications

(25 citation statements)

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“…Brownish-black or tea colored urine is generally seen in hemoglobinuria and myoglobinuria arising from sepsis, crush injuries, hypokalemia, and inflammatory myopathies and urine generally turns this color in presence of acidic urine [8]. It can also be associated with copper, phenol, cresol, alkaptonuria, melanuria, and treatment with L-dopa and alpha methyldopa [8]. Poisoning due to cresol [9], endosulfan, and paraphenylene diamine is known to cause black urine due to the presence of phenolic metabolites.…”

Section: Discussionmentioning

confidence: 99%

“…Poisoning due to cresol [9], endosulfan, and paraphenylene diamine is known to cause black urine due to the presence of phenolic metabolites. Red urine is generally due to hematuria, but vegetables like rhubarb, beetroot (due to betalain and seen in 10 to 14% of population), and blackberries [8]; metabolites like methemoglobin, melanin, porphyrin, and homogenitisic acid; medications like chloroquine, deferoxamine, ibuprofen, iron sorbitol, nitrofurantoin, phenytoin, rifampicin, vitamin B12, doxorubicin, phenazopyridine, phenolphthalein, and topical application of azosulfamide (alternative/complementary medicine) can also cause a similar discoloration [8]. Orange urine has been attributed to hemoglobin, myoglobin, porphyria, methemoglobinemia, iron (hemochromatosis), beetroot pigment, rifampicin and conjugated hyperbilirubinemia [8, 10].…”

Section: Discussionmentioning

confidence: 99%

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Unusual Complications of Quinalphos Poisoning

Viswanathan

2013

Case Reports in Emergency Medicine

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This 40-year-old man was treated for suicidal quinalphos 25%EC consumption. He developed intermediate syndrome with normal response to repetitive nerve stimulation, pancreatitis with high enzyme elevations, and normal computed tomography and excreted black, brown, and orange urine sequentially over the first nine days of hospitalization. The last complication has not been previously reported with any organophosphate compound. He finally succumbed to complication of ventilator associated pneumonia related septic shock and ventricular tachycardia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Unusual Complications of Quinalphos Poisoning

Viswanathan

2013

Case Reports in Emergency Medicine

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“…Normal freshly-voided urine is pale yellow to deep amber in color (Boye et al, 2012). Cloudy urine may indicate an infection of the urinary tract (Foot and Fraser, 2006). Pale yellow and clear urine is usually associated with increased production of dilute urine whereas deep yellow concentrated urine occurs as a result of dehydration with free water conservation (Foot and Fraser, 2006).…”

Section: Introductionmentioning

confidence: 99%

Macroscopy and Microscopy Urinalysis: A Vital Screening Procedure for Urinary Tract Infections (UTIs) in a Hospital in Awka, Nigeria

Nwankwo¹,

Ezebialu²,

Ezeadila³

et al. 2020

JBLS

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Urine examination has been employed in clinical practice as the most common screening laboratory method for early detection of urinary tract infections (UTIs) or renal disorder. This study was undertaken to ascertain the usefulness of urine macroscopy and microscopy as vital screening procedure for diagnosing UTI among antenatal patients in a teaching hospital in Awka, Nigeria. Freshly voided midstream urine specimens of 269 pregnant women were collected and examined using macroscopic, microscopic and culture methods. The sensitivity, specificity, positive predictive value and negative predictive value of urine colour, and microscopic features were compared with urine culture in diagnosis of UTI. Statistical analysis was done using SPSS and Epi info® and P-value was set at <0.05 significant level. One hundred and seven specimens showed positive urine cultures. Out of these 107 specimens, 60 (56.1%) also had deviation from normal urine colour and 77(72%) were positive on urine microscopy. Macroscopic examination showed that a significant relationship exists between urine colour and positive urine culture (p=0.0001). The sensitivity and specificity of urine colour with respect to UTI were 56.7% and 67.9% respectively. Urine microscopy revealed that the positive features had a significant relationship with positive urine culture (p= 0.000). Pyuria alone showed the specificity and positive predictive value of 100% each. The sensitivity, specificity, positive predictive value and the negative predictive value of combination of positive microscopic features were 72%, 64.8%, 57.5% and 77.8% respectively. Examination of colours and microscopic features of urine are therefore vital in predicting urinary tract infection.

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“…A spectrum of urinary colours have been observed down the ages that have aided visual diagnosis of systemic diseases 1 . Urinary discoloration occurs depending upon urochrome concentrations and the presence of exogenous or endogenous pigments.…”

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confidence: 99%

“…Urinary discoloration occurs depending upon urochrome concentrations and the presence of exogenous or endogenous pigments. Foot and Fraser in 1996 had elegantly described 10 urinary colours and their causes 1 . Green urine has been reported in association with bilirubin, dyes, herbicides, Pseudomonas infections (pyocyanin and pyoverdin), drugs like propofol, metoclopramide, triamterene, amitryptiline, cimetidine, indomethacin, methocarbamol, oral breath mints, excessive mouthwash use and infections like typhus 2,3 .…”

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Common Poison, Uncommon Urine

Viswanathan¹,

John

2011

Nephrology

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The Epstein-Barr virus (EBV) infection commonly manifests as fever, malaise, cervical lymphadenitis, pharyngitis and splenomegaly. Leucocytoclastic vasculitis is a rare complication of acute EBV infection. Clinical manifestation is often limited to the skin, but the renal, gastrointestinal or pulmonary system may be involved. 1 We report a case of leucocytoclastic vasculitis with crescentic glomerulonephritis in association with acute EBV infection.n ep_1440 617.. 618 A 14 year old male presented to us with history of sudden onset of fever and skin rashes initially over the trunk and gradually involving the entire body including the face for 10 days. He was febrile and breathless with a blood pressure of 110/60 mmHg. He had conjunctival suffusion with a diffuse erythematous maculopapular rash. Systemic examination revealed hepatosplenomegaly with pulmonary congestion. His laboratory investigations revealed thrombocytopenia (87000/cmm) with acute renal failure (creatinine 1.7 mg/dL). Urinalysis showed 2+ proteinuria, haematuria and red blood cell casts with spot urine protein to creatinine ratio of 1.74. His blood and urine culture was negative and 2-D echocardiography was normal. Serum complement 3 and 4 levels were low and vasculitis work-up was negative. Serum for EBV capsid antigen (VCA) was highly positive with increasing titres. He had normal bone marrow studies and skin biopsy suggestive of leucocytoclastic vasculitis. He was treated with i.v. ceftriaxone and other supportive measures but he continued to have high grade fever with worsening azotemia (creatinine 5.2 mg/dL). Percutaneous kidney biopsy revealed severe proliferative glomerulonephritis with cellular crescents in more than 50% of the glomeruli (Fig. 1). He was treated with i.v. methyl prednisolone 500 mg once daily on 3 consecutive days followed by 1 mg/kg day p.o. Following this, his respiratory symptoms subsided, rashes started fading and his urine output improved. His serum creatinine dropped to 0.8 mg/dL with disappearance of proteinuria and haematuria.The finding of leucocytoclastic vasculitis on skin biopsy is suggestive of small-vessel vasculitis. The possible pathophysiological mechanism is either direct invasion of endothelial cells by EBV or by immune complex-mediated inflammation. Renal involvement in EBV infection is predominantly interstitial, 2 overt renal failure is uncommon 3 and crescentic glomerulonephritis has never been reported.Crescentic glomerulonephritis and small-vessel vasculitis in the presence of Ig M VCA antibodies in our patient may have resulted from an intense immune response to the EBV infection. Simultaneous decrease in C3 and C4 indicating classical complement activation along with prompt response to immunosuppressive therapy supports this possibility. Thus, we hypothesize that EBV infection should be included in the differential diagnosis while treating a patient with crescentic glomerulonephritis.We report a 35-year-old man with suicidal carbofuran ingestion who developed shock, renal failure and excreted g...

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Uroscopic rainbow: modern matula medicine

Abstract: Visual inspection of a patient's urine has long been used by physicians, with colour recognised as having important clinical implications. In this review the authors will revisit this ancient pastime with relevance to contemporary medical practice.

Cited by 26 publications

References 37 publications

Unusual Complications of Quinalphos Poisoning

Unusual Complications of Quinalphos Poisoning

Macroscopy and Microscopy Urinalysis: A Vital Screening Procedure for Urinary Tract Infections (UTIs) in a Hospital in Awka, Nigeria

Common Poison, Uncommon Urine

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