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In medicine, bilirubinuria is an abnormality in which conjugated bilirubin is detected in the urine. [1] The term "biliuria" is very similar, but more general. It refers to the presence of any bile pigment in the urine. Conjugated bilirubin is detected in urine at bilirubinemia of approximately 30-34 mmol/L or 2 mg/dL.
Urine bilirubin may also be clinically significant. [59] Bilirubin is not normally detectable in the urine of healthy people. If the blood level of conjugated bilirubin becomes elevated, e.g. due to liver disease, excess conjugated bilirubin is excreted in the urine, indicating a pathological process. [60]
Choluria (or bilirubinuria) is a symptom defining an abnormal darkness of the urine, mainly due to a high level of conjugated bilirubin. [1] [2] Choluria is a common symptom of liver diseases, such as hepatitis and cirrhosis. It can be described as dark or brown urine, often referred to as the color of Coca-Cola.
Urine: conjugated bilirubin present, urobilinogen > 2 units but variable (except in children) Plasma proteins show characteristic changes. Plasma albumin level is low, but plasma globulins are raised due to an increased formation of antibodies. Unconjugated bilirubin is hydrophobic, so cannot be excreted in urine.
Conjugated bilirubin is normally stored in the gallbladder as a constituent of bile and is excreted through the intestines; it does not occur at detectable levels in the urine. [81] The presence of bilirubin in the urine (termed bilirubinuria) occurs as a consequence of high blood levels of conjugated bilirubin in liver disease or bile duct ...
Automatic analysis of urine test strips using automated urine test strip analysers is a well-established practice in modern-day urinalysis. They can measure calcium , blood, glucose, bilirubin, urobilinogen, ketones, leukocytes, creatinine , microalbumin , pH, ascorbic acid and protein.
Conjugated bilirubin, being water-soluble, is excreted through urine. Hence, dark urine tested bilirubin positive signifies conjugated hyperbilirubinemia. [3] A peripheral blood smear showing signs of haemolysis. Red blood cells are normally in a biconcave shape (round cells in this picture).
Results from the urine test should be confirmed by a complete blood count (CBC) and serum testing for total serum bilirubin and fractionated bilirubin. [32] Increased reticulocytes and the presence of schistocytes in the blood smear of the patient observed during CBC indicates hemolysis . [ 28 ]