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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.
Unconjugated bilirubin is hydrophobic, so cannot be excreted in urine. Thus, the finding of increased urobilinogen in the urine without the presence of bilirubin in the urine (due to its unconjugated state) suggests hemolytic jaundice as the underlying disease process. [39]
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 ]
Hyperbilirubinemia is a clinical condition describing an elevation of blood bilirubin level due to the inability to properly metabolise or excrete bilirubin, a product of erythrocytes breakdown. In severe cases, it is manifested as jaundice, the yellowing of tissues like skin and the sclera when excess bilirubin deposits in them. [1]
Foamy urine is considered a cardinal sign of proteinuria, but only a third of people with foamy urine have proteinuria as the underlying cause. [2] It may also be caused by bilirubin in the urine (bilirubinuria), [3] retrograde ejaculation, pneumaturia (air bubbles in the urine) due to a fistula, [4] or drugs such as pyridium. [3]
Urine urobilinogen is increased in liver disease and hemolytic jaundice (jaundice due to increased destruction of red blood cells); in the latter case, urine bilirubin is typically negative. In bile duct obstruction, urine bilirubin increases but urobilinogen is normal or decreased, as bilirubin cannot reach the intestines to be converted to ...